Fillable PROPERTY INFORMATION (Fountain Hills Sanitary District)

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PROPERTY INFORMATION (Fountain Hills Sanitary District)

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16941 E. Pepperwood Circle
Fountain Hills, AZ 85268
Phone: (480)-837-9444
FAX TO: 480-837-0819 OR EMAIL TO: fhsd@az-fhsd.gov
PROPERTY INFORMATION
Close of escrow date_______________________________________________ Escrow #___________________________________________________________
Legal description _______________________________________________________
Parcel number _________________________________________
Property address_________________________________________________________________________________________________________________________
SELLER INFORMATION
Sellers name_____________________________________________________________________________ Phone #________________________________________
Forwarding address______________________________________________________________________________________________________________________
City_____________________________________ State_____________ Zip_________________ Email____________________________________________________
BUYER INFORMATION
Buyers name____________________________________________________________________________ Phone #_________________________________________
Mailing address__________________________________________________________________________________________________________________________
City_________________________________________ State_____________ Zip__________________ Email_______________________________________________
TITLE COMPANY INFORMATION
Title company name__________________________________________________ Fax #____________________________ Phone # __________________________
Title company address___________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________
Escrow Officer (Please Print and Sign Name)
SEWER USER FEES: (Applies to improved property) AVAILABILITY FEES: (Applies to vacant land only)
(Prorate between Seller and Buyer) (Prorate between Seller and Buyer)
Sewer User Fees $__________________ per quarter
Availability Fees $_______________________ Annually
From______________________To___________________________ From______________________To_______________________________
In addition, please collect from the buyer only $____________________For the next quarter of_____________________to______________________
Amount due $__________________________ + Establishment fee $___________________________ $_________________________
Notes___________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________
NOTICE OF EASEMENT: If this box is checked, the property owner should be aware that an active easement may be present on the
property. Nothing may be constructed or planted within an active easement without permission from the Sanitary District first.
ABANDONMENT or ENCROACHMENT letter for this property is attached, please provide copy to the new buyer.
________________________________________________________________________ DATE_______________________________ Date Closed________________
Customer Service Representative Signature
Check #____________________
___________________________ ___________________________
BOOK-ACCOUNT #
CSR_______________________
Revised: 12-2020
INFORMATION BELOW FILLED IN BY FOUNTAIN HILLS SANITARY DISTRICT
For Internal Use Only
FOUNTAIN HILLS SANITARY DISTRICT
TITLE INQUIRY FORM
Has not been paid
Has been paid
Has not been paid
(Collect from Buyer)
= TOTAL DUE TO FHSD
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PROPERTY INFORMATION (Fountain Hills Sanitary District)

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Completed 1 February 2021

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