Ambassador Abstract LLC

Client Information

My name:	*
Company name: (if applicable)	*
My street address: (Line 1)	*
My street address: (Line 2)
My city:	*
My state:
My zip:	*
My Phone Number:	*
My Fax:	*
My email address:	*

On this transaction I am the:	Buyer's Attorney
	Buyer
	Lender
	Lender's Attorney

Lender Name:
Lender Phone:
Amount of Loan (if any):	$

Address of Property

Number/Street:	*
City/State/Zip:	*
Section:
Block:
Lot:

Attorney for Lender:
Attorney for Lender Phone:

Borrower(s):
Borrower(s) Phone:

Attorney for Borrower (if any):
Attorney for Borrower (if any) Phone:

Proposed Closing Date:

Additional comments or notes: