Buyer Questionnaire

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What is the address of the property being sold?*
Street Address City State ZIP Code
What is the purchase price of the property being sold?*
Is the Buyer willing to sign an official tax disclosure stating all of the following?*
• The Buyer has acquired the property for personal use only
• Buyer or Buyer's family intends to reside in the property for at least 50% of the days that any person resides in the Property. Only the days the property is actually occupied has been considered in the statement
• The period of personal use will commence on the date of Closing & continue for at least 24 consecutive months:
- Yes
- No
How many buyers are there? (If more then two then contact us)*
- One
- Husband / Wife
- Two
What is the Buyer’s legal name(s)?*
Click the "plus" symbol to add another name.
First Last
What is the Buyer’s email address?*
Click the "plus" symbol to add another email.
Email
What is the Buyer’s best phone number?*
What is the Buyer’s Social Security Number (SSN) (Please enter your 9 digit number, no spaces or dashes. Info will be sent through our encrypted, secure server)*
Click the "plus" symbol to add another Social.
Social Security Number Name (as it appears on your SS Card)
What is the Buyer’s best mailing address?*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Title Company Information
Name of Title Company
Escrow Officer Name
Email of Escrow Officer
Phone # of Escrow Officer
Realtor Contact Information
Name of Broker Company
Name of Individual Realtor
Their Email Address
Their Phone Number
Who referred you to us?
List
Name
First Last
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Payan & Payan LLC
7936 W Sahara Ave.
Las Vegas, Nevada 89117
Phone: (702) 233-9526
Fax: (702) 255–3622
Email: cpas@p2cpa.com

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First	Last

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Social Security Number	Name (as it appears on your SS Card)

Buyer Questionnaire

Click the "plus" symbol to add another name.

Click the "plus" symbol to add another email.

Click the "plus" symbol to add another Social.

Title Company Information

Realtor Contact Information