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Title Insurance Order

Application Date

Date Needed

Closing Date

Purchase Price

Loan Policy

Owner's Policy Yes No

Loan Type

Purchaser

Purchaser's Current Address and Phone Number

Seller

Seller's Current Address and Phone Number

Property Address

County

Tax I.D. No.

Property Being: Purchased Refinanced

Legal Description Abstract Torrens

Legal Description

Certificate Number (if Torrens)

Property Type 1-4 Family Residential
Condo
Townhouse
Vacant Land
New Construction
Other

Description (if Other)

Prior Title Evidence Title Policy Abstract RPA None

Existing Mortgage With

Loan No.

Listing Broker / Agent

Phone

Selling Broker / Agent

Phone

Services Required Plat Drawing
Special and Pending Assessments
Other
Closing

Other Description

Closing at which office

Endorsements Comprehensive
Location
Environmental Lien
Variable Rate
Condo / Townhouse

Copies of Commitment to:

Ordered By

Firm

Address

Phone

Send copy to my email:

Email

Send Copy to My Email

Thank You for Your Submission.

Abstract Service Company • 111 NW 5th Street, Grand Rapids, MN 55744
218-326-9010 • 218-326-8030 (Fax)