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Please fill in the following form which will be submitted to the office of Arthur Keledjian and Jack Tahanian.

Buyer Name (1):
Buyer Name (2):
Date of birth (1):
Date of birth (2):
Social Security (1):
Social Security (2):
Phone number:
Property address:
City, State, ZIP
Year built:
Square foot:
Central Air: Yes No
Pool / Spa: Yes No
Garbage disposal: Yes No
Trash compactor: Yes No
Garage door opener: Yes No
Additional water heater: Yes No
Escrow Officer:
Escrow Officer Tel:
Escrow Number:
Remarks:

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