101 Plaza East Blvd. Suite 102
Evansville, IN 47715
Phone (812) 402-6555
Fax (812) 402-6575

Real Estate Information Form

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Listing Agent: Selling Agent:
Company: Company:
Fax: Fax:
Phone: Phone:
Property Address
Street: City:
State: Zip:

Buyer: Seller:
We have received the order for title and a copy of the purchase agreement. Please take a moment to complete this form or download the hardcopy and fax it back as soon as possible to 812-402-6575 or email to closings@truetitlein.com
Purchase Price: Earnest Deposit:
Held By:
  %  on  $ Even Split:
Closing Allowance:
Home Warranty $ Payable to:
Pest Inspection $ Payable to:
Pest Treatment $ Payable to:
Home Inspection $ Payable to:
Repairs $ Payable to:
Other $ Payable to:
Seller Mortgage
Account # Lender:
Agent Contacts
Listing Agent E-mail: Selling Agent E-mail:
Please be advised, effective July 1, 2009, HEA 1374 (enacting Indiana Code 27-7-3.7) requires Good Funds for real estate transactions.

Funds received from any party to the transaction in an amount of $10,000 or more MUST be in the form of an irrevocable wire transfer. Funds received from any party in an amount less than $10,000 MAY be in the form of irrevocable wire transfer, cashier’s check, certified check, check drawn on the escrow account of another closing agent, or check drawn on the trust account of a licensed real estate broker.