Riefberg Real Estate and Relocation Servicesas an agent for AIReS

9 Old Sugar Hollow Road

Danbury, CT 06810

(203) 744-RIEF

Property Information

Owner:______Social Security #: Last four digits______

Spouse/Co-owner:______Social Security#: Last four digits______

Property Address:______

First Mortgage Information **(Please include a copy of your most recent coupon/statement)

Name of Lender: ______

Address payments are sent to: ______

Phone #:______Loan #:______

Automatic Draft: Yes No Interest Rate:______% Fixed Variable

Is there a Pre.-Payment penalty? Yes No If Rate variable, date of change______

Monthly payment amount $______

Second Mortgage Information **(Please include a copy of your most recent coupon/statement)

Name of Lender: ______

Address payments are sent to: ______

Phone #:______Loan #:______

Automatic Draft: Yes No Interest Rate:______% Fixed Variable

Is there a PRE-Payment penalty? (would be in note) YesNo If Rate variable, date of change______

Monthly payment amount $______

Monthly Payment amount $______

Equity Line of Credit Information **(Please include a copy of your most recent coupon/statement)

Name of Lender: ______

Address payments are sent to: ______

Phone #:______Loan #:______

Automatic Draft: Yes No Interest Rate:______% Fixed Variable

Is there a PRE-Payment penalty? (would be in note) YesNo If Rate variable, date of change______

Monthly payment amount $______

Additional Mortgages or Liens (please provide information below)

______

______

Homeowner’s Association

Do you have an HOA? Yes No

Name of Association______

Address: ______

Phone Number: ______Contact:______

Management Company:______Phone:______

Amount of Dues: ______Are they paid MonthlyAnnuallyQuarterly?

House Information (Answer as applicable)

  1. Sewer System:
  2. Private Septic ______
  3. City Sewer____ **Name & Phone # of Sewer Company ______
  4. Community Sewer ______
  1. Water:

1. Private Well______

2. City Water _____ **Name & Phone # of Water Company______

3. Community Water ____

  1. Fuel Oil:

Yes______Name of company______

No______Phone number______

  1. Buried Oil Tank:

Yes____Insurance Policy______

No______Contact/Phone #______

  1. Propane:

Yes______

No______

  1. Fire Tax District:(if you pay a separate tax to your local fire dept)______
  1. Title Insurance Policy : ______

(Please include a copy of your Owners Policy of Title Insurance)

  1. Current Listing Agent: ______Phone Number:______
  1. Do you currently have flood insurance on your property?

Yes____If Yes, Insurance Policy______

No______Contact/Phone #______

  1. Do you carry any additional type of property insurance? (ie: wind, earthquake, etc)

Yes______(If so please provide details below)

No______

  1. Name of Attorney/Escrow Company That Represented You When You Purchased:

(Name)______(Phone Number)______

  1. Name of Attorney/Escrow Company That Represented You If you ever Refinanced a loan:

(Name) ______(Phone Number) ______

The Above Information is truthful, accurate and complete.

______

Signature OwnerSignature Co-Owner and/or (Spouse)

New Address and Phone Number (If you do not have one now, please let us know ASAP where you can be reached)

______

1 | PageAIReS/RRERS Property Information Sheet