Short Sale Form

Title Holder Information

First Name

Last Name

Middle Initial

Is the title holder an entity?

YesNo

Entity Name

Signer Name

Position

SSN or TINWe will call for this

Street Address

City

State

Zip

Email Address

Phone Number 1

Phone Number 2

Fax

Borrower Information

First Name

Last Name

Middle Initial

Is the title holder an entity?

YesNo

Entity Name

Signer Name

Position

SSN or TINWe will call for this

Street Address

City

State

Zip

Email Address

Phone Number 1

Phone Number 2

Fax

Property Information

Property Street

Property City

Property State

Property Zip

Property Country

Legal Description

Parcel #

Notes

Lender Information

Trust Lender

Contact Info

Lender Phone #

Loan #

Borrower Information

Coordinator Name

Coordinator Entity

Phone Number

Email Address

Dates

Vacate Date

Notice of Default Date

Trustee Sale Date

Transaction Date

Submit

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