Advantage America Title & Closing Services, Inc.
		Customer: Sales Representative: ED MICHALEK LAURIE SMART-LLOYD JJ JUNG ERIN GONZALES MONICA ANDERSEN CHRIS CHARLES DARCI FROEMMING GARY GUSZKOWSKI HOUSE ACCOUNTS CHOOSE ONE E-mail Address: Property Address: City: Zip code: Seller's Name: Marital Status: Married Single Choose One Home Phone: Work Phone: Social Security Number: Social Security Number: Has Seller occupied property in the last 6 months? Yes No Choose One Has work been done on the property in the last 6 months? Yes No Choose One ** Original lien waivers to be furnished at closing. Will Buyer occupy the property? Yes No Choose One Will Seller be attending the closing? Yes No Choose One Buyer's Name: Buyer's Address: City: Zipcode: Buyer's Lender: Phone Number: Fax Number : Earnest Money $ Commission %: Commission $: Listing Broker $: Selling Broker $: Home Warranty? Yes No Choose One Company Name: Phone Number: Amount $: Condo/Homeowner's Assoc.? Yes No Choose One Association Name Association Phone: Association Fax: Rental Property? Yes No Choose One Tenants #1 Rent $: Security Deposit $: Tenants #2 Rent $: Security Deposit $: Seller's Mortgage  Payoff Information: 1st Mortgage Lender: 2nd Mortgage Lender: Accnt. # 2nd Accnt. # Pricing: Resale Land Development C-CAP/KBG CMH Spec Home Choose One
Brookfield 300 N. Corporate Dr. - Suite 270 Brookfield, WI 53045 Phone (262) 879-0082 Toll Free (877) 626-0082 Fax (262) 879-0092 Closing Dept. Fax (262) 317-1874 aabrookfield@advantageamericatitle.com Green Bay 1290 Lombardi Ave Green Bay, WI 54304 Phone (920)405-0052 Fax (920) 405-0062 aagreenbay@advantageamericatitle.com Madison 6417 Odana Rd - Suite D Madison, WI 53719 Phone (608) 442-8464 Fax (608) 442-8476 aamadison@advantageamericatitle.com