Homeland Title Services Form

Homeland Title Services, Inc. is a privately owned title insurance agency located in Clermont, Florida. The founders of HomeLand Title Services, Inc. are Victoria Burns (Vicki), Deanna Alaniz.

Property Information

Property Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Listing Agent Information

LISTING AGENT COMPANY

Listing Agent Company Phone

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Max. file size: 50 MB.

Listing Agent Name

Listing Agent Email

Listing Agent Phone

Broker License #

Sales person license #

Office Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Selling Agent Information

SELLING AGENT COMPANY

AGENT

Office address

Phone #

Broker License #

Sales person license #

Cell #

SELLER

Phone #

Mail away?

Yes

BUYER

Phone #

Mail away?

Yes

Commission

% to Listing Agent

% to Selling Agent

Bonus (if any)

Transaction fee

Home Warranty

Yes

Paid by Seller or Buyer (circle one) $

and Warranty Company name

SELLER PAYOFF INFORMATION:

Mortgage Company

Cust. Svc. Ph. #

Account #:

Last of #’s of Social Sec. #

HOMEOWNERS ASSOCIATION CONTACT INFORMATION

Homeland Title Services Form

Property Information

Listing Agent Information

Selling Agent Information

SELLER PAYOFF INFORMATION:

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