Request More Info

First Name

Last Name

Enter Name (if different from client Name)

Street Address

Address line 2

City

State

Zip code

Enter Your Email

Confirm Your Email

Your Number

Is there more than 1 Exchanger for this account?

Yes No

If there will be 2 Exchangers for this account, is the other Exchanger your spouse?

Yes No

Should the exchange funds be held as joint tenants with right of survivorship? This means that if one of you died, funds in the account would automatically pass to the survivor (not the decedent’s estate) upon death. NOTE: This does not apply to accounts in which the Exchangers are trusts.

Yes No

First Name

Last Name

Enter Name (if different from client Name)

Street Address

Address line 2

City

State

Zip code

Enter Your Email

Confirm Your Email

2nd Exchanger's Cell Phone (MUST be different than 1st Exchanger's cell phone)*

Are there any additional Exchangers?

Yes No

if yes, IPX1031 will get additional info from you

Contact Number

Name of person IPX1031 should contact (if different from Exchanger)

Contact Info

Email or phone for person IPX1031 should contact

Relinquished Property Information: (Property being sold)

Please complete as much information as possible

Property Address*

Street Address

City

State

Zip code

Do you have further Relinquished Property info?

Yes No

Parcel Number (APN)

Sales Price ($)

Estimated Closing Date

Buyer Name

Seller will offer Carryback Financing?

Yes No

Explain what the Carryback Financing is.

Closer (Escrow Company / Settlement Agency) for Relinquished Property Sale

Do you have Closer (Escrow/Settlement) info?

Yes No

Contact Name

First Name

Last Name

Company Name

Mailing Address

Mailing Address 1

City

State

Zip code

Phone

File Number

Real Estate Agent/Broker Information (if any)

Do you have Real Estate Agent/Broker info?

Yes No

Agent Name

First Name

Last Name

Company Name

Mailing Address

Mailing Address 1

City

State

Zip code

Phone

Alternate Phone

Exchanger's Attorney (if any)

Do you have any Attorney info?

Yes No

Attorney Name

First Name

Last Name

Firm Name

Mailing Address

Mailing Address 1

City

State

Zip code

Phone

Exchanger's Tax Advisor (if any)

Do you have Tax Advisor info?

Yes No

Advisor Name

First Name

Last Name

Firm Name

Mailing Address

Mailing Address 1

City

State

Zip code

Phone