Charlevoix Abstract & Title

Order for Title Work

Fields marked with * are required

From (Bill to):

Company:

Address:

City, State, Zip:

*Email:

Date:

Need by:

Phone:

Fax:

P.A. Attached: Pages:

Check all that apply:

1) The person/company ordering this is:
Listing Agent
Selling Agent
Mtg. Broker
Lender:
Other:

2) Please provide me with the following:
Title Search
Preliminary Commitment

Owners Policy #:

Lenders Policy #:

Refinance $:

Other - Earnest Money Dep.:

Commission:

Closing Date (or TBD):

3) Buyer(s)/Borrower(s):

Name:

Address:

City, State, Zip:

4) Seller(s)/Current Owners:

Name:

Address:

City, State, Zip:

5) Lender to be shown on title work:

Same as billing

Address:

City, State, Zip:

Email:

Phone:

Fax:

Additional Information

Send copy to:

Legal Description/Tax ID No.

Send title work to billing address:

Previous Title Work (please submit with order for re-issue credit):

Type in the code:

Instructions