Thank you for allowing MIRA LAW LLC to handle the sale of your home. Please take few moments to complete this information. Failure to provide this information in a timely manner may result in a delayed closing. We look forward to working with you and making this a smooth transaction for all. Please call our office at (678) 503-5000 or email precloser@miralaw.net should you have any questions or issues. *Any and all information you submit through this website is transmitted securely using industry-standard safeguards Property Address * Forwarding Address After the Sale * If you don't have one, indicate property address Address 1 Address 2 City State/Province Zip/Postal Code Country Seller #1 * First Name Last Name Name of Entity, if Not an Individual Indicate Whether this is an LLC, Corporation or Other LLC Corporation Other -Trust, Partnership Social Security Number or Tax ID, if Entity * Email * Are You a US Citizen * If you are NOT a US Citizen, you may be subject to FIRPTA withholdings Yes No Are You a Georgia Resident * If NO, Provide the State of Residence Yes No Phone * Country (###) ### #### Seller #2 First Name Last Name Email Are You a US Citizen * If You are NOT a US Citizen, You May Be Subject to FIRPTA Withholdings Yes No N/A Are You a Georgia Resident * If NO, Provide the State of Residence Yes No N/A Social Security Number / Tax ID * Phone Country (###) ### #### MORTGAGE INFORMATION Lender's Name Phone Number (###) ### #### Loan Number If There's a Second Mortgage, Please Provide the Loan Details Below PROPERTY INFORMATION Is This a Mobile Home? * Yes No Is There an HOA? * Yes No Water Servicer * City County Billed Thru the HOA Well on Property N/A -Vacant Land Will the Property Be Vacant at Closing? * Yes No -Tenant Occupied Temporary Occupancy Are All Persons on Title Still Living? * Yes No CLOSING INFORMATION Will All Sellers Attend Closing? * If NO, There May Be Additional Fees for Your Selected Option Yes No (indicate which option you prefer) Are Seller's Going Through a Divorce? * If YES, We Will Need to Review Your Settlement Agreement Yes No Does Any Seller's Current Legal Name Differ from the Name as it Appears on the Recorded Deed? * If Anyone has Gotten Married or Divorced, Please Provide the Necessary Supporting Documents Yes No Is Any Seller in an Active Bankruptcy? * Yes -Call our Office Immediately No At Closing, I Prefer a Check or Wire for My Proceeds * Check Wire Thank you for providing your seller information!
