Data can be typed directly into this form.
Page 1 of 2
Once you have saved it, please send using:
Or Fax: 888-876-3583
Reverse Exchange Worksheet
for Leasehold Improvements
Exchangor Information:
Name:
□
Individual(s)
□
Trust
□
Partnership
□
Corporation State of Formation:
□
Other
Contact Person, if not an Individual:
Mailing Address:
Phone:
Email:
Affiliate / Titleholder Information:
□
LLC
□
Corporation
□
Partnership
□
Other
Name:
State of formation
Property Information
Address or Legal Description:
County:
State:
Date acquired by Affiliate:
Brief description of improvements to be made
Estimated value of improvements
Relinquished Property Information:
Address or Legal Description:
County:
State:
Expected Close Date:
Estimated amounts, if known:
Expected Sale Price:
Mortgage Payoff:
Cost Basis:
Data can be typed directly into this form.
Page 2 of 2
Once you have saved it, please send using:
Or Fax: 888-876-3583
Reverse Exchange Worksheet
for Leasehold Improvements
Exchangor’s Legal / Tax Advisor, if any:
Firm Name:
Contact Name:
Phone:
Email:
Replacement Property Lender, if any:
Firm Name:
Contact Name:
Phone:
Email:
Relinquished Property Escrow / Closer, if known:
Company Name:
Contact Name:
File #
Phone:
Email: