Prescott Septic Services

Property Owner

Seller's First Name *

Seller's Last Name *

Service Address *

Parcel Number *

Seller's Phone *

Seller's Email *

Title Company

Title Company Name *

Title Company Agent *

Title Company Email *

Title Company Phone *

Close of Escrow Date *

Seller's Agent

Sellers Agent Company *

Seller Agent Name *

Seller Agent Phone *

Seller Agent Email *

Buyers Info

Buyers Name

Buyer's Phone Number

Buyer's Email

Buyer's Agent

Buyer's Agent Name

Buyer's Agent Phone

Buyer's Agent Email

Additional Notes

Is water available on site: *

Yes

Locked Gates *

Yes

Animals:

Water Source (IE well, hauled, municipal): *

Projected Close of Escrow

When was Septic tank last pumped? *

Is the house vacant? *

Yes

If yes, how long has it been vacant? *

Has there been any documented or undocumented repairs done that we need to know about prior to inspection? *

Payment Through Escrow?: *

Yes

*If Yes- Invoice must be paid in full if the close of escrow exceeds 30 days from service date.

*If Yes- Seller authorizes escrow to pay inspection fee from seller’s proceeds at closing.
This authorization does not relieve seller of responsibility for payment if escrow fails to close.

Number of Bedrooms/Bathrooms:

By signing this contract, the undersigned ("Signee") acknowledges and agrees to the prices listed above, as outlined in the agreement. In the event that the property falls out of escrow for any reason, the Signee agrees to be responsible for the full payment of the invoice, including any additional fees or costs that may arise as a result of the escrow cancellation. These fees may include, but are not limited to, administrative costs, cancellation fees, and any other charges that may be incurred due to the change in status of the transaction.

Payment of the full invoice amount is due on or before the invoice due date, regardless of the escrow status. The Signee understands and agrees that payment is required by the specified due date, and failure to make full payment by the due date may result in legal action or other collection efforts.

Signature *

Clear

Signature Name *

Thank you again and we look forward to doing business with you.

- Jared