Application for Title Insurance

We will respond to all email inquiries within 24 hours. If your question requires immediate attention, please call our office at 952-252-2500. Fax the following to 952-252-2505: Purchase Agreement (if applicable). If requesting reissue credit, please include previous title policy or HUD1 Statement. Red indicates a required field.

General Information
Date Sent:	Date Needed:	Closing Date:

Type:

Residential

Vacant Land

New Construction

Mortgage Information

Type:		Mortgage Amount: $
If First Mortgage:		FHA VA CONV
Please Check all that Apply:	Plat	Name Search Special Assess Priority Pictures

Property Information

Property Address:	Street:
	County:
	City, State, Zip:	, ,
Borrower's Name(s):			SS#:
			SS#:
Phone #'s:	Home:	Work: Work:
Mailing Address:	Street:
(if different)	County:
	City, Sate, Zip:	, ,

Lender Information

Lender:

Loan Officer:

Phone#:

Fax#:

Processor:

Lender's Address:	Street:
	City, State, Zip:	, ,

Payoffs:	Lender's Name:	Acct#:	Phone#:
	Lender's Name:	Acct#:	Phone#:

Proposed Insured:

Seller Information (if purchase)

Purchase Price: $

Seller Name(s):

Address:	Street:
	County:
	City, State, Zip:	, ,
Phone #'s:	Home: Work: Work:

Listing Agency:
Listing Agent:
Street Address:
County:
City:
State, Zip:	,
Phone:
Fax:

Selling Agency:
Selling Agent:
Street Address:
County:
City
State, Zip:	,
Phone:
Fax: