Purchase/Sale Order Form

Date: ________________

Ordered by:__________________Phone:______________

Company:____________________Fax:________________

 

Listing Agent:_________________________Phone:___________________

Company:______________________Fax:_____________________

Selling Agent:_________________________Phone:___________________

Company:______________________Fax:_____________________

Loan Officer:________________________Phone:___________________

Company:______________________Fax:_____________________

Owner:________________________SSN:_________________

Owner:________________________SSN:_________________

Property Address:

Street:________________________________________

City:__________________State:____ZIP____________

Tax ID Number:________________________

Sales Price:$____________________ 

New Loan Amount:$______________

Endorsements: 8.1 100 116 PUD 6.0 ARM (Please Circle)

Are there water shares/water rights/well water rights involved?

___ yes ___ no

If so, please fill out the following:

Which water company is involved? _______________________

How many shares? ___________

Claim number? ______________

Please fax a copy of the REPC or applicable purchase agreement with this order.  Thank you!

Other Instructions:_______________________________

_______________________________________________

_______________________________________________

Please fill in all appropriate blanks and fax to the appropriate office.

Thank you very much for using our website and we will be in contact with you soon!   

Logan Office Fax (435)752-3612 

11 W Center, Logan, UT 84321

Garden City Office Fax (435)946-4012

115 S Bear Lake Blvd., Garden City, UT 84028

Preston Office Fax (208)852-9300

96 South State, Preston, ID 83263

Montpelier Office Fax (208)847-0881

680 N 4th Suite 1, Montpelier, ID 83254

Malad Office Fax (208)766-7702

215 East 50 South Suite #5,  Malad, Id 83252

Afton Office Fax (307)885-3602

290 S Washington, Afton, WY 83110

Evanston Office Fax (307) 789-2017

849 Front Street Suite 103, Evanston, WY 82930

Kemmerer Office Fax (307)877-1206

727 Cedar Avenue, Kemmerer, WY 83101

Rock Springs Office Fax (307) 362-8833

1471 Dewar Drive #106, Rock Springs, WY 82901

Pinedale Office Fax (307)367-3742

110 North Jackson, Pinedale, WY 82941