Listing Agent Questionnaire

Fill out all the information below. Click SUBMIT when finished.
Download the Information Authorization Disclosure Form, and have your client sign it, then EITHER:
- Email or fax it back to us, or
- Upload it as an attachment at the bottom of this form
Are the funds going to be wired? Download the Wire Funds Form, fill it out, and email or fax it back to us. ($75 fee)

Important Information

File #

This is the number provided in the email sent to you

Is the Seller a person(s), entity, or trust?

Which regional MFTS location are you working with?

Property Address

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

Listing Agent Information

Name

First Last

Office

Office Address

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

Cell Phone #

Fax #

Agent License #

Broker License #

Broker Office Phone #

Transaction Information

Final Sale Price

Total Commission %

Listing Agent %

Selling Agent %

Listing Agent Admin Fee (Broker Commission)

If you refer to it as something other than Admin Fee, please put it here:

Based On

Earnest Money Deposit Amount

Held By

Bring to Closing?

Seller Information

Name of Seller 1

First Last

Last 4 digits of SS#

Forwarding Address

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

Marital Status

Name of Seller 2

First Last

Last 4 digits of SS#

Forwarding Address

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

Marital Status

Cell Phone #

Either Seller's #

Work Phone #

Either Seller's #

Either Seller's Email

Will all Sellers & Spouses be at closing?

Payoffs to Be Ordered

Mortgage To

Account #

Customer Service Phone #

Mortgage To

Account #

Customer Service Phone #

We will obtain the payoff(s), but will need the seller’s signature authorization, as well as the mortgage account information requested above. Please have seller sign and return to MFTS.

Home Information

Has there been or will there be a termite inspection on the property?

Will there be a home warranty involved in this transaction?(Required)

Homeowner's Association?

NOTE: Mulloy/Paragon and Omni charge approximately $195 to Seller to obtain info.

Special Instructions/Notes

Please give any special instructions or notes here:

Information Authorization Disclosure

Max. file size: 50 MB.

Name

This field is for validation purposes and should be left unchanged.

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Listing Agent Questionnaire

Important Information

Listing Agent Information

Transaction Information

Seller Information

Payoffs to Be Ordered

Home Information

Special Instructions/Notes

Louisville

St. Matthews

Elizabethtown

Mt. Washington

New Albany

Cincinnati

Lexington