Seller's Information:
Name:
Status:
Address:
City:
State:
Zip:

Buyer's Information:
Name:
Status:
Address:
City:
State:
Zip:

How Title will be held by Buyer: Tenants by the Entirety (Husband & Wife Only) Joint Tenants Join Tenants with Full Rights of survivorship Tenants in Common Other (Trust, Corp., Partnership, LLC, Etc.
(If "Other", please specify:
Purchase Price: $
Special Provisions: (i.e. reservations, division rights)

Complete only if Land Contract (or mortgage):
Down payment $
Interest rate %
Monthly P/I
Balloon payment	Years

Property Information:
Property Tax ID No.:
County:
City/Twp:
Manufactured Home?	Yes  No
If yes, provide make and serial no. in Comments, below.
Description: (prefer copy of prior document if available)

Additional Comments:

THE UNDERSIGNED HEREBY REQUESTS DOCUMENT PREPARATION SERVICES OF LAKESHORE LAND AND TITLE, AND UNDERSTANDS THAT ALL DOCUMENTS ARE PREPARED BY RICHARD A RANDALL, ATTORNEY, UNDER DIRECTION OF THE GRANTOR.

ORDER PLACED BY:
PHONE:

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