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Purchase Application - The Lovett Group of Real Estate Companies

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Page 1 <strong>of</strong> 4<br />

110-20 71st Road Apartments, Inc. John B. <strong>Lovett</strong> & Associates, Ltd.<br />

Barclay Plaza 109-15 14 th Avenue<br />

110-20 71st Road College Point, New York 11356<br />

Forest Hills, NY 11375<br />

COOPERATIVE PURCHASE APPLICATION<br />

<strong>Purchase</strong>r:_______________________________________________<br />

<strong>Purchase</strong>r:_______________________________________________<br />

<strong>Purchase</strong>r’s Attorney:______________________ Telephone:______________<br />

Attorney’s Firm and Address:________________________________________<br />

________________________________________<br />

________________________________________<br />

________________________________________<br />

Building:_______________________ Apartment No.:_________________<br />

Number <strong>of</strong> Shares:________________ Monthly Maintenance:____________<br />

<strong>Purchase</strong> Price:__________________<br />

Name on Stock Certificate and other documents:___________________________<br />

___________________________<br />

___________________________<br />

Financing: ______No ______Yes Amount:________________<br />

Bank:__________________________________<br />

__________________________________<br />

<strong>Real</strong> <strong>Estate</strong> Broker:_________________________<br />

Company:_______________________________<br />

Address:________________________________<br />

________________________________<br />

Telephone :______________________________<br />

Seller’s Name:__________________________________________________<br />

Forwarding Address:________________________Telephone:_______________<br />

________________________<br />

________________________<br />

Seller’s Attorney:__________________________ Telephone:_______________<br />

Attorney’s Firm and Address:_________________________________________<br />

_________________________________________<br />

_________________________________________<br />

Anticipated Closing Date:____________________<br />

Anticipated Date <strong>of</strong> Possession:________________<br />

Revised 3/14/13 YVC 11

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