FrickTrentLizzio, PLLC
141 Providence Road STE 110
Charlotte, NC 28207
Phone: 704-376-8181

Buyer Info Form

If you would like to submit the information below via fax instead, then please download our buyer info offline form.

Be assured that all information submitted here is safe and secured.

This information will be used to prepare all closing documents. Please complete this form accurately and legibly.
Will you be present for closing? *
Yes, I will be present for closing
I will close with Power of Attorney for my spouse (Please note our office must obtain prior approval from your lender in order to use a Power of Attorney)

Title Information

Please spell your full legal name below. This information will be used on the Warranty Deed (as well as the Power of Attorney, if applicable). Please note you must use the same name(s) given to your lender.
Your Name *
  Full Legal Name of Spouse

Contact Info - Prior to closing

Please indicate an address and telephone numbers where you can be contacted prior to closing. The address must be a street address, so that we may send information via Federal Express if necessary.
Name *
  Address *
Work Phone *
  Cell Phone *
Home Phone *
  Fax Number *
Home Email *
  Work Email *

Contact Info - After closing

Please provide and address and phone number where you can be reached after closing.
Address *
  Phone *

Lender Information

Lender *
  Lender Address *
Lender Phone *
  Lender E-mail *
Loan Number *
  Loan Contact *

Realtor Information

Real Estate Firm *
  Agent Name *
Realtor Phone *
  Realtor Email *

Homeowners Information

Insurance Company Name *
Insurance Company Address *
  Insurance Company Phone *

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