Info Sheet Letter - Buyer

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INFORMATION SHEET

Escrow No.: FSBC-0272104009-MZ Title No.: FWPS-TO21003158

PLEASE FILL OUT THIS FORM COMPLETELY AND RETURN TO OUR OFFICE AS SOON AS POSSIBLE
AS IT WILL ASSIST US IN THE ADMINISTRATION OF YOUR TRANSACTION.
1. Buyer(s): Text
Home No.: ( ) Work No.: ( )
Fax No.: ( ) Work No.: ( )
Cell No.: ( ) Cell No.: ( )
E-Mail Address:
Social Security No.: Social Security No.:
Buyer(s) Current Mailing Address:

2. Buyer(s) Mailing Address After Close of Escrow:

3. Buyer(s) Vesting to be Placed on Grant Deed, Please Print Your Name Exactly as You Wish it to
Appear of Record:

Please mark appropriate box:


 Husband and Wife  Wife and Husband
 A Married Couple  A Single Man (never married)
 A Single Woman (never married)  A Single Person (never married)
 An Unmarried Man (divorced)  An Unmarried Woman (divorced)
 An Unmarried Person (divorced)  Registered Domestic Partners
 A Widow (spouse deceased)  A Widower (spouse deceased)
 A Married Man (as his sole and separate property)*  Other
 A Married Woman (as her sole and separate property)*
 A Married Person (as his/her sole and separate property)*
*Please indicate name of spouse so interspousal deed may be drawn.

As:
 Community Property
 Community Property with Right of Survivorship
 Joint Tenants
 Tenants In Common (Please indicate each party’s undivided interest: ________%)
 Sole and Separate Property (If Married or Domestic Partnership, an Interspousal Grant Deed, A
Quitclaim Deed, Statement Of Information and Appropriate Instructions Will Need To Be Submitted.)
 Partnership (Limited Or General)
 Corporation (California Or Other State)
 Limited Liability Company (California Or Other State)
 A Trust (attach copy of Trust Agreement)
 Other

Info Sheet (Letter) Printed: 09.10.21 @ 10:51 AM by MZ


SCA0002218.doc / Updated: 06.12.20 Page 1 CA-FT-FSBC-01500.080027-FSBC-0272104009
4. New Loan(s) Buyer(s) are Applying For:
Name Of Lender:
Address:
Agent's Name: Phone No.: ( )
E-Mail Address: Fax No.: ( )
Name Of Lender:
Address:
Agent's Name: Phone No.: ( )
E-Mail Address: Fax No.: ( )

5. New Insurance:
Agent's Name: Phone No.: ( )
E-Mail Address: Fax No.: ( )
Agent's Address:
Insurance Company:

Please place any additional information that you feel we may require on the reverse side of this form.
IN WITNESS WHEREOF, the undersigned have executed this document on the date(s) set forth below.

___________________________________
Alfredo Montalvo Date

___________________________________
Anastacia Lopez Perez Date

PLEASE COMPLETE, DATE, SIGN AND RETURN

Stillwater Insurance Group can provide a free, no obligation homeowner insurance quote that meets all
your mortgage requirements. Call today at toll-free (888)333-2120 to avoid any delays in your property’s
closing.

Info Sheet (Letter) Printed: 09.10.21 @ 10:51 AM by MZ


SCA0002218.doc / Updated: 06.12.20 Page 2 CA-FT-FSBC-01500.080027-FSBC-0272104009

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