Replacement Property Form

Role
You Are?
Exchanger
Escrow Officer/Closing Attorney
Real Estate Agent/Broker
Other

Name

Email

Asset Preservation Contact


Escrow Officer/Closing Attorney
Name

Escrow Company

Address

City

State/Zip

Phone

Fax

Email

Escrow or File Number


Exchanger
Exchanger Vesting
(Entity purchasing property)

Name

Address

City

State/Zip

Phone

Other Phone

Email


Exchanger's Real Estate Agent/Broker
Name

Address

City

State/Zip

Phone

Email


Purchase Property
Property Address/Description

City

State/Zip

County

Property Type


Seller
Seller Vesting
(Entity selling property)


Seller's Real Estate Agent/Broker
Name

Address

City

State/Zip

Phone

Email


Transaction Details
Purchase Price
$

Estimated Closing Date


Additional Information
Additional Information

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If other, please describe