Purchase Submission Form Submit a buyer sale First Name Last Name Street Address of Property Effective Date of Contract Email Message Buyer 1 NAME First Name First Name Last Name Buyer 1 Email Buyer 1 Email Buyer 1 Email Buyer 1 Phone Area Code Phone Number Buyer 2 Name First Name Last Name Buyer 2 Email Buyer 2 Email Buyer 2 Phone Area Code Phone Number Is the property vacant? Yes No Lender/Mtg Broker NAME First Name Last Name Lender/Mtg Broker EMAIL Email Lender/Mtg Broker NAME Lender/Mtg Broker PHONE Area Code Phone Number Title Company Info (IF NOT LISTED ON PG1) Cooperating Agent NAME First Name Last Name Cooperating Agent EMAIL Email Address Cooperating Agent PHONE Area Code Phone Number Commission percentage Commission percentage Transaction Fee/Flat Fee Commission Charged? Yes no Is there a referral to be paid out? Yes no NOTE DISCLOSURE: By completing this form and delivering your contract, you are hereby hiring Committed2Closing LLC to begin working on your contract and authorizing us to collect a processing fee at closing. All payments not received within two weeks post closing, are subject to a $50 late fee. Submit
