To: Investors Title Exchange Corporation Attention: Exchange Coordinator Telephone: 800/724-8791 Fax: 800/653-9811 Email: exchanges@invtitle.com
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From: (Name)*
Telephone:
Fax:
Email:
How did you hear about ITEC? Check all that apply
Attorney Realtor Seminar Publication Closer Other (Internet/Trade Show/Etc.)
Exchange Information:
EXCHANGOR:
Name: Spouse's Name: Is Spouse on Title? Yes No Address: City: State: Zip Code: Telephone: Fax: Email: Tax ID Number:
COUNSEL (The Attorney or CPA advising you):
Name:
Mailing Address:
Telephone:
Fax:
Email:
Relinquished Property: (Fax a copy of the contract(s) for the sale of relinquished property to 1-800-653-9811 or you may email it to exchanges@invtitle.com) Property Description: Title held in the name(s) of: Buyer's Name: Effective Date of sales contract: Contract Price:
CLOSING INFORMATION:
Settlement Agent:
Closing Date:
Address:
City:
State:
Zip Code:
Telephone:
Fax:
Email:
Will Seller Be at Closing? Yes No
Will Buyer Be at Closing? Yes No
Replacement Property (If Known):
(Fax a copy of the contract(s) for the purchase of replacement property to 1-800-653-9811 or you may email it to exchanges@invtitle.com)
Property Description: Title to be held in the name of: Seller's Name: Effective Date of sales contract: Contract Price:
CLOSING INFORMATION:
Settlement Agent:
Closing Date:
Address:
City:
State:
Zip Code:
Telephone:
Fax:
Email:
Will Seller Be at Closing? Yes No
Will Buyer Be at Closing? Yes No