General Abstract and Title Agency - Mercerville, New Jersey

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You have requested that we have a deed, affidavit of title and 1099 prepared for your sale of property. In order to process your request more efficiently, we will need the following information. Please take a moment to fill out this form and return it to me.

*Required Fields are in bold

Mailing Address:

your name(s)
street:
suite/apt:
city:
state:
zip code:
home phone number:
work phone number:
cell phone number:
email address:

Marital History:

date of marriage:
maiden name:

Have you been previously married? If so, please list dates of previous marriages and divorces. If you are a widow/widower, please give the date of death of your spouse.

Social Security Numbers:

husband:
wife:

Date of Birth:

husband:
wife:

Drivers' License Numbers:

husband:
wife:

Address of Property
Being Sold (if applicable) :

street:
suite/apt:
city:
state:
zip code:

Is Property being sold/refinanced your primary Residence:

Yes

Type of Residence Being Sold or Refinanced:

		Single Family		Condo
		Townhouse		Other

Name of First Mortgage Holder:
Account Number:
Phone Number for Customer Service:

Name of Second Mortgage Holder:
Account Number:
Phone Number for Customer Service:

If the property being sold is a condominium or townhouse, please furnish name, address and phone number of the association:

street:
suite/apt:
city:
state:
zip code:
phone number:

Your forwarding address (if applicable):

street:
suite/apt:
city:
state:
zip code:

We appreciate your time in filling out this form. Please be aware that we need this returned in order to complete the processing of your file. Any delay may cause a delay in you closing. If you have any questions, please do not hesitate to give us a call.


		Order a Title Search
		Buyers' Information Form
		Sellers' Information Form
		Borrowers’ Info Form - Refinance