Start an Exchange – Doug Blackwell

Thank you for contacting IPX1031. We look forward to working with you. When completing the below order form, please provide us with as much information as possible. Please note – you can submit your order form without all the fields completed. We will contact you once your order is received to discuss your upcoming exchange transaction. If you have any questions, please contact me at 506-367-6701 or toll free at 888-310-1031.

Client Information

Client Name (Exchanger - the Relinquished Property Seller)*

First Last

Entity Name (If different from client name)

Street Address

Street Address Address Line 2 City State ZIP Code

Email*

Enter Email Confirm Email

Cell Phone*

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

2nd Exchanger's Contact Information*

First Last

2nd Exchanger's Street Address

Street Address Address Line 2 City State ZIP Code

2nd Exchanger's Email (MUST be different than 1st Exchanger's email)*

Enter Email Confirm 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 Name

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

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

Contact Name

First Last

Company Name

Mailing Address

Street Address City State ZIP Code

Phone

Email

File Number

Real Estate Agent/Broker Information (if any)

Agent Name

First Last

Company Name

Mailing Address

Street Address City State ZIP Code

Phone

Alternate Phone

Email

Exchanger's Attorney (if any)

Attorney Name

First Last

Firm Name

Mailing Address

Street Address City State ZIP Code

Phone

Email

Exchanger's Tax Advisor (if any)

Advisor Name

First Last

Firm Name

Mailing Address

Street Address City State ZIP Code

Phone

Email

Should somebody else receive copies of the 1031 exchange documents?

If so, who?

Attorney identified above
Tax Advisor identified above
Other (supply contact info below)

Name

First Last

Relationship

Mailing Address

Street Address City State ZIP Code

Phone

Email

Who referred you to IPX1031?

Worked with IPX1031 before
Closing (escrow/settlement agency) identified above
Attorney identified above
Tax Advisor identified above
Real Estate agent/broker identified above
Self
Other (please supply below)

Name

First Last

Company

Mailing Address

Street Address City State ZIP Code

Email

Phone

Thank you for your business.

Additional information we should know.

CAPTCHA

Start an Exchange – Doug Blackwell

Client Information

Relinquished Property Information: (Property being sold)

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

Real Estate Agent/Broker Information (if any)

Exchanger's Attorney (if any)

Exchanger's Tax Advisor (if any)

Should somebody else receive copies of the 1031 exchange documents?

Who referred you to IPX1031?

Thank you for your business.

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