Order Title Insurance

Step 1: Order Information (Required)

Who is placing the order:
—Please choose an option—Listing AgentSelling AgentLenderBuyerSellerOther

Full Name:

Email:

Phone:

Purchase or Refi:
PurchaseRefi

Step 2: Property Information (Required)

Property Address:

Property State:

Selling Price:

Closing Date:

Step 3: Seller Information

SELLER 1

Full Name:

Phone/Cell:

Email:

Marital Status:

Is The Address The Same as Property Address?
YesNo

If No, Please Enter Address:

Will Seller 1 Attend Closing?
YesNo

If No, Provide Address To FedEx Documents:

SELLER 2 (If Applicable)

Full Name:

Phone/Cell:

Email:

Marital Status:

Is The Address The Same as Property Address?
YesNo

If No, Please Enter Address:

Will Seller 2 Attend Closing?
YesNo

If No, Provide Address To FedEx Documents:

MORTGAGE PAYOFF

Bank Name

Loan Number:

Bank Phone:

REPRESENTATION

Does Seller Have Attorney Representation?
YesNo

If Yes, List Attorney Contact Information:

Step 4: Buyer Information

BUYER 1

Full Name:

Phone/Cell:

Email:

Marital Status:

Address:

Will Parties Attend Closing?
YesNo

If No, Provide Address To FedEx Documents:

BUYER 2 (If Applicable)

Full Name:

Phone/Cell:

Email:

Marital Status:

Address:

REPRESENTATION

Does Buyer Have Attorney Representation?
YesNo

If Yes, List Attorney Contact Information:

Step 5: Realtor Information

LISTING AGENT

Company:

Agent:

Email:

Phone:

Cell:

Agent ID Number:

SELLING AGENT

Company:

Agent:

Email:

Phone:

Cell:

Agent ID Number:

TOTAL COMMISSION % FOR TRANSACTION

Listing Agent % :

Listing Agent Transaction Fee :

Selling Agent % :

Selling Agent Transaction Fee :

Step 6: Lender Information (Optional)

LENDER / MORTGAGE/ BANK INFO

Company:

Contact:

Loan Amount:

Email:

Phone:

Address:

Step 7: HOA Information

Management Company:

HOA Monthly Fee:

HOA Contact:

HOA Phone:

Additional HOA/POA Info:

Step 8: Additional Information

Enter Any Additional Info:

Attach a File

Max Combined File Size: 10MB

Reminder: Be sure to have parties schedule HOA interview.