e1031xchange Questionnaire

To begin the paperwork on the exchange, please provide the following information:

Owner 1:

Full name of the first owner of the property being sold:

Is the owner an entity (LLC, Trust, Corp., ...etc.)?

Yes No

Please indicate who is the authorized signatory:

Full mailing address including (street, city, state, zip):

Cell phone number:

Email:

Percentage ownership of property:

Tax ID Number:

SSN EIN

SSN:

EIN:

Tax resident state:

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington, DCWest VirginiaWisconsinWyoming

Are you subject to back up witholding (your tax advisor would have told you if you are)?:

YesNo

Are there any other property owners who will be doing an exchange?

YesNo

Owner 2:

Full name of the second owner of the property being sold:

Please indicate who is the authorized signatory:

Full mailing address (street, city, state, zip):

Cell phone number:

Email:

Percentage ownership of property:

Tax ID Number:

SSN EIN

SSN:

EIN:

Tax resident state:

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington, DCWest VirginiaWisconsinWyoming

Are you subject to back up witholding (your tax advisor would have told you if you are)?:

YesNo

Are there other property owners who will be doing an exchange?

YesNo

Owner 3:

Full name of the third owner of the property being sold:

Please indicate who is the authorized signatory:

Full mailing address (street, city, state, zip):

Cell phone number:

Email:

Percentage ownership of property:

Tax ID Number:

SSN EIN

SSN:

EIN:

Tax resident state:

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington, DCWest VirginiaWisconsinWyoming

Are you subject to back up witholding (your tax advisor would have told you if you are)?:

YesNo

Relinquish Property Information:

Full address of property being sold:

Is the property in contract?:

YesNo

Is there a tentative closing date?

YesNo

What is the tentative date of the closing?:

Please provide the following for the lawyer/title company/settlement agent handling the sale:

Name:

Telephone number:

Email address:

Sales price of the property:

How did you find us? (Google, Referral, etc.)

ReferralGoogleYahooOther

Name of referral:

If other, please indicate:

Submit