Broker Order – Seller Side – BCA Title Services

Broker Order – Seller Sidetitleservices2026-09-24T16:39:36+00:00

Broker Order – Seller Side

If you are acting as both the listing and selling agent, please complete and submit the Broker Order – Buyer Side form as well.

If you represent only the seller, please ask the selling agent to complete and submit the Broker Order – Buyer Side form. If the property has an outstanding mortgage, the seller must complete and sign the Payoff Authorization form. The completed form may be emailed, faxed or delivered to our office.

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Ordered by(Required)

First Last

Due by(Required)

Closing Date(Required)

Purchase Price(Required)

County

Brief Legal Description

Tax ID or Parcel Number(Required)

Property Address(Required)

Street Address City State ZIP Code

Buyer Name(Required)

First Last

How many sellers?

Seller One Name(Required)

First Last

Seller One Phone(Required)

Seller One Email(Required)

Seller One Current Address(Required)

Street Address City State ZIP Code

Seller Two Name(Required)

First Last

Seller Two Phone(Required)

Seller Two Email(Required)

Seller Two Address(Required)

Street Address City State ZIP Code

Seller Three Name(Required)

First Last

Seller Three Phone(Required)

Seller Three Email(Required)

Seller Three Address(Required)

Street Address City State ZIP Code

Seller Four Name(Required)

First Last

Seller Four Phone(Required)

Seller Four Email(Required)

Seller Four Address(Required)

Street Address City State ZIP Code

Will any of the seller's address(es) change after sale?

Yes

Please list which seller(s) addresses will change after the sale, as well as their new address.

Seller's property is:(Required)

Is there a current mortgage on the property?

Yes

Is there a prior title policy?(Required)

Yes, we can provide a prior title policy for reissue credit

No, we cannot provide a prior policy

Please email a copy of your prior title policy to Office@BurnettCountyAbstract.com

Is there a manufactured home on the property?

Yes

Manufactured Home ID#, Year, Make, Width & Length:

Does the seller have the manufactured home title?

Yes

Earnest Money?(Required)

Yes

Earnest Money Amount(Required)

Will BCA Title Services be holding the earnest money funds?(Required)

Yes

Name of Listing Agent

First Last

Listing Agent Company

Listing Agent Phone Number

Listing Agent Email

Selling Agent Name

First Last

Selling Agent Company

Selling Agent Phone

Selling Agent Email

Commission Rate

If commission rate is an unusual split, please explain here:

Are there any broker fees, and who pays them?

Additional charges to be added to the closing statement:

Will BCA Title Services be handing the closing?(Required)

Yes

Will Seller be Coming to Closing?(Required)

Yes

Is there an attorney representing the seller?(Required)

Yes

Attorney Name

First Last

Attorney Phone

Attorney Email

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