Horizon Settlement Services, Inc.

Submit Your Seller Information

Seller Information

Personal Information (* indicates a required field.)

Your Name:*

Your Telephone:

Home:

Work:

Your Email Address:

Co-Seller Name:

Co-Sellerr Telephone:

Home:

Work:

Your Address:*

City*, State*, Zip:

Your Attorney (If any or, If not our office):

Your Attorney Address:

City, State, Zip:

Phone:

Your Real Estate Broker:

Phone:

Mortgage Payoff Information

Current First Mortgage Lender:

Loan/Account Number:

Lender Telephone:

Current Equity / Second Mortgage Lender:

Loan/Account Number:

Lender Telephone:

Notes or Special Instructions to us: