Order Information:


Realtor Name:                                                                             
           
Company name:                                                                            

cell phone:                                                                              

office phone:                                                                             

office fax:                                                                             

Email:                                                                             

Ordered By:                                                                             
             
Office Phone:                                                                            

Email:                                                                              

Estimated Close Date:                                                                             


               

Residential:                                                                             
         
New Construction:                                                                            

vacant land:                                                                              

                             
Property Type:
Transaction Type:


1. Purchase:                                                                             
    
Cash sale                    Lender                          
                              
2. Refinance:                                                                             

1st Mortgage                                                             

1st & 2nd Mortgage                                                             

HELOC                                                              


                             
Property Information:

Street:                                                                             
         
City:                                                                            

State:                                                                             

Zip:                                                                             

Land Lot:                                                                             

District:                                                                             

Subdivision:                                                                             
Realtor Information:  (if applicable)
Buyer/Borrower Information:

First Name:                                                                             
       
Last Name:                                                                            

Home Phone:                                                                             

Office Phone:                                                                             

First Name:                                                                             

Last Name:                                                                              

Home Phone:                                                                             

Office Phone:                                                                            
Seller Information:

First Name:                                                                            

Last Name:                                                                            

Co-Seller:                                                                             

Home Phone:                                                                             

Cell Phone:                                                                             

Work/Office Phone:                                                                             
Location:


Marietta                       Vinings                       Cartersville          
Additional Information:

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WILSON & MILLS, LLC
ATTORNEYS AT LAW
Wilson & Mills, LLC
Marietta
Vinings
Cartersville
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