Real Estate Work Order

To send a closing or title order to Baillie & Hershman P. C., please fill out the form below.

Processing will begin promptly. Thank you.

Transaction Type: 

Property Address
Street: 
City / State / Zip: 
County: 

Seller Information
Seller Name: 
Address: 
Home Phone: 
Business Phone: 
Mobile Phone: 
Fax: 
Email: 
SS#: 
Employer: 
Attorney Name: 
Attorney Firm: 
Attorney Address: 
Attorney Phone: 
Attorney Mobile: 
Attorney Fax: 
Attorney Email: 

Buyer Information
Buyer Name: 
Address: 
Home Phone: 
Business Phone: 
Mobile Phone: 
Fax: 
Email: 
SS#: 
Employer: 
Attorney Name: 
Attorney Firm: 
Attorney Address: 
Attorney Phone: 
Attorney Mobile: 
Attorney Fax: 
Attorney Email: 

Mortgage Broker
Broker Name: 
Address: 
Contact: 
Phone: 
Mobile: 
Fax: 
Email: 

Lender
Lender Name: 
Address: 
Contact: 
Phone: 
Mobile: 
Fax: 
Email: 

Listing Broker
Agency Name: 
Address: 
Business Phone: 
Home Phone: 
Mobile Phone: 
Fax: 
Email: 
Agent: 
Commission:  %   $
Purchase Price:  $
Deposit: 

Selling Broker
Agency Name: 
Address: 
Business Phone: 
Home Phone: 
Mobile Phone: 
Fax: 
Email: 
Agent: 
Split:  /
Closing Date: 
Paralegal: 
Schedule Closing:  Real Estate Agent   Bank Client   Attorney
Order Notes: