Pacific Coast Escrow Corporation Escrow SALE Request
This form will help you open your Escrow. Please make sure that you fill
out ALL fields appropriate to your escrow.
We suggest printing the page and filling it out PRIOR
to filling it in on the web.
Property & Seller Information
PROPERTY
ADDRESS
SELLER CONTACT INFO
City,
State, Zip
Seller
Home Phone
SELLER
NAME
Mobile
Phone
Seller
Address
Work
Phone
Seller City, State, Zip
Fax
Seller
Email
Buyer Information
BUYER
NAME
BUYER CONTACT INFO
Buyer
Address
Buyer
Home Phone
Buyer
City, State, Zip
Mobile
Phone
Buyer
Email
Work
Phone
Fax
Buyer
Vesting
Single Man (Never Married)
Single Woman (Never Married)
Widow
Widower
Married
Man as His Sole & Separate Property
Married
Woman as Her Sole & Separate Property
Unmarried Man (Divorced)
Unmarried Woman (Divorced)
Husband & Wife,
as Joint Tenants
Husband
& Wife, as Community Property
Husband
& Wife, as Community Property wRight to Survivorship
Husband &
Wife, as Tenants in Common
Buyer
Escrow Deposit
All
Cash?
Yes
No
Purchase
Price
Type
of Loan
Conventional
FHA
VA
Length
of Escrow
Seller
Carry Back?
Yes
No
New Loan Amount
Reports & Policies
Termite
Report
Yes
No
Who
Pays for Repairs SECTION I
Buyer
Seller
Termite
Company
Who
Pays for Repairs SECTION II
Buyer
Seller
Termite Co. Mailing Address
Termite Co. Phone
Home Warranty
Policy
Yes
No
Home Warranty; Who Pays?
Buyer
Seller
Home Warranty Company
Home Warranty Company Phone
Warranty Co. Mailing Address
Natural Hazard Report
Yes
No
Who Will Order and Process Report?
Listing Agent
Escrow Company
Listing Broker Commission
LISTING
Broker Company
LISTING
AGENT
Listing
Broker Co. Address
Listing
Broker Phone
Listing
Agent Commission
%
Mobile
Total
Commision
FAX
Selling Broker Commission
SELLING
Broker Company
Selling
Broker Co. Address
Selling
Broker PHONE
Selling
Agent Commission
Selling
Broker Mobile
SELLING
AGENT
Selling
Broker FAX
Fees, Dues, Costs & Credits
Is there a Homeowners Association?
Yes
No
Is Buyer Going to Occupy Property?
Yes
No
Who Will Pay for Transfer
Fee If Any?
Buyer
Seller
Closing Costs Credits from
Seller
Prorate Property Taxes?
Yes
No
FHA VA Non Allowables
Prorate HOA Dues?
Yes
No
Special Instructions:
Lender & Title Company
Lender
Company
Title
Company
Lender
Address
Sales
Rep for Title Co
LOAN
OFFICER
Lender
PHONE
Seller Normal Costs and
Charges?
Yes
No
Lender
FAX
Buyer Normal Costs and Charges?
Yes
No