AGENT

First Name*

First name*

Agent Last name*

Last name*

Email*

Phone*

Are you a Buyer, Agent, or Investor?

Your GA Real Estate License Number*

Real Estate License Number*

Your Brokerage Name*

Brokerage Name*

Your Brokerage License Number*

Starts with H-#####*

Your Buyer(s) Name(s)*

If your buyer is purchasing the property in the name of a business, please also include the entire business name.*

OFFER TERMS | PRICE

Property Address*

Complete Address*

Purchase Price*

Seller-Paid Closing Costs*

Will your buyer be offering the Seller any non-refundable Option Money?*

Yes No I don't know

This field is required.

CONTINGENCIES

Due Diligence Period*

Number of days*

Financing Contingency Period*

Number of days*

Appraisal Contingency Period*

Number of days*

FINANCING

Loan Type*

Lender*

OTHER DETAILS

Proposed Closing Date*

mm/dd/yyyy

Proposed Possession Date (If your Buyer is allowing a temporary occupancy period for the Seller after Closing, what is the date that period will be over?)*

mm/dd/yyyy

Proposed Closing Attorney*

Proposed Earnest Money Amount*

Does your Buyer's offer include an escalation clause?*

Yes No I don't know.

This field is required.

Is this purchase contingent upon the sale or lease of Buyer's other property?*

Yes No I don't know.

This field is required.

Does your Buyer's offer include the following recommended special stipulation: "All deadlines and contingency termination dates referenced in the Agreement shall end at 8:00 PM Eastern Time unless otherwise specified. Should any deadline and/or contingency termination date fall on a date that is not a business banking date (i.e., a weekend or federal holiday), said deadline and/or contingency termination date shall be moved to the following business banking date."*

Yes No

This field is required.

Does your Buyer's offer include any additional special stipulations?*

Yes No I don't know.

This field is required.

Does your Buyer's offer require a deadline for acceptance?*

Yes No I don't know.

This field is required.

I agree.

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Contact Information

OFFER TERMS | PRICE

CONTINGENCIES

FINANCING

OTHER DETAILS

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AGENT

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