1. Exchangor's Personal Information
Exchangor's Name(s)	1. 2.
Address
City
State
Zip
Social Security No(s)	Exchangor 1. Exchangor 2.
Exchangor's Phone	Cell Phone:
Exchangor's Fax
Contact Email Address	*required

2. Address of Each Property Being Sold (Old Property)
Property 1 Address
Property 1 City
Property 1 State
Property 2 Address
Property 2 City
Property 2 State
Additional Property

3. Real Estate Agent Information
Name
Phone	Fax:
Agent's Email

4. Contract Information
Selling Price of Old Property 1	$
Contract Date for Property 1
Name(s) of Old Property 1 Buyer	Name 1. Name 2.
Projected Closing Date for Old Property 1:
Selling Price of Old Property 2	$
Contract Date for Property 2
Name(s) of Old Property 2 Buyer	Name 1. Name 2.
Projected Closing Date for Old Property 2:

5. Escrow or Closing Agency where your transaction is being/will be handled
Name
Address
City
State
Zip
Phone	Fax:
Escrow Email
Escrow Officer Assigned
Escrow Number

6. Accountant or Tax Advisor Information
Name
Address
City
State
Zip
Phone	Fax:
Accountant's Email

7. Other Exchange Information

a. Will you be transferring or receiving substantial personal property in the exchange?   YES          NO   If YES, what value has been set for such property? Value Transferred:  $       Value Received:  $

b. Are you giving or receiving any promissory notes, cash or non-like-kind property in this transaction?   YES        NO     If so, describe:

8. When available, transmit to LEX the following documents

A copy of the Sales Contract for each Old Property A copy of the Preliminary Report on each Old Property (prepared by Title Company) (Omit Boilerplate Sections)

END OF INITIAL INFORMATION SECTION

TRANSMIT TO LEX TO BEGIN EXCHANGE PROCEDURE

- NEXT SECTION FOR REPLACEMENT PROPERTY -

When Replacement Propert(ies) have been identified provide:
9. Replacement Property Information
Property 1 Address
Property 1 City
Property 1 State
Purchase Price of Property 1:	$   Contract Date Projected Closing Date:
Property 2 Address
Property 2 City
Property 2 State
Purchase Price of Property 2:	$   Contract Date Projected Closing Date:
Name(s) of Replacement Property Seller
Property 1	Name 1. Name 2.
Property 2	Name 1. Name 2.
Comments
Escrow or Closing Agency Handling Replacement Property Transaction
Name
Address
City
State
Zip
Phone	Fax:
Escrow Officer
Escrow Email
Escrow Number
Sales Contract and Preliminary Report for Replacement Property
When Available Transmit:	Copies of the Sales Contract and Preliminary Report for each Replacement Property (Omit Boilerplate Sections)

END OF FORM

Please review all answers and click submit ^ TOP OF FORM ^