Buyer Form

Settlement Date:

Purchaser(s):

Seller(s):

Property Address:

Our File No:

BUYER(S) MARITAL STATUS:

Married

Unmarried

Separated

Widowed

Divorced

PHONE # (W)

(H)

Email:

NEW LENDER:

COMPANY:

LOAN OFFICER:

PHONE NUMBER:

Is POWER OF ATTORNEY to be used?

YES

FROM:

TO:

NOTE: POWER OF ATTORNEY MUST BE APPROVED BY LENDER &
GREENBRIER; FAX COPY TO GREENBRIER.

Do you wish Greenbrier to Draft the Power of Attorney?

YES

HOME WARRANTY?

YES

COMPANY:

COST:

RENTBACK:

YES

DATES:

PLEASE PROVIDE A COPY OF POST-SETTLEMENT
OCCUPANCY AGREEMENT

ASSIGNMENT OF FUNDS:

Is buyer having funds from the sale of property assigned to Greenbrier?

YES

ANY SPECIAL CREDITS? (Such as preoccupancy or closing costs)

List:

Jane Oliver Smith ▌Greenbrier Settlements, LLC ▌9403 Grant Avenue
Manassas, Virginia 20110 ▌(703) 366-2668 ▌(703) 366-2667 (fax)
jsmith@shaclaw.com ▌© 2004 Greenbrier Settlements L.L.C.