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    Rush Resale Certificate Request Form

    Property Information

    Address:

    City:

    Zip:

    Current Owner(s):

    Requesting Party Information

    Name:

    Relationship to Owner:

    Address:

    Email:

    Telephone Number:

    Delivery Information

    How should FCCSA deliver the Resale Certificate? (please select one)
    *FCCSA will provide within three(3) days of receipt of request and fee

    **Other Address:

    $375.00 Fee Must Accompany this Request in Order for FCCSA to Process a Resale Certificate

    $250.00 TRANSFER FEE WILL BE DUE AT CLOSING
    (REFER TO STATEMENT OF ACCOUNT) to request a SOA email acctg@firstcolony.org

    Credit Card:
    Transaction Fee: $11.25

    Amount:

    Card Number:

    Exp Date:

    Name:

    Security Code:

    Email:

    Phone:

    Signature:

    Date: