Full Name:  (Contact information:  email address, phone #’s)

Marital Status: Married      Not Married    Common Law (living together for more than 3 years)

Municipal Address of Property:

Legal Description if known:

Closing Date: (If closing date is tentative, kindly indicate Preferred Closing Date.)

Purchase Price:     

If a purchase, are all Purchaser first Time Buyers.    Yes      No 

Mortgage.  Yes      No  (Will a mortgage/Line of Credit be required to complete the purchase?)

If yes, Name of Bank: (Name of Banker & Contact Information  - email or phone #)