APPLICATION FOR TITLE INSURANCE

13954 Cypress Drive Suite 200

Baxter, MN 56425

Phone: 218-829-4450

Fax: 218-829-4617
APPLICATION FOR TITLE INSURANCE
Select all that apply *

Purchase Title lns Only Refinance Title lns & Closing New Construction Mail Out Closing 2nd Mortgage Jr. Lien Policy
Application Date: *

Month Day Year
Date
Estimated Closing Date: *

Month Day Year
Date
Full Name of Borrower #1 *

First Name Last Name
Phone Number *

Area Code Phone Number
SSN # *
Email *
example@example.com
Full Name of Borrower #2

First Name Last Name
Phone Number

Area Code Phone Number
SSN #
Email
example@example.com
Borrower(s) Present Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Property Address *

Street Address

County

City State / Province

Postal / Zip Code
Parcel Number *
Do you have a prior File *

Yes No Abstract Torrens
REQUIREMENT: A compete legal description will need to be furnished with the title application. Without the complete legal description the file will be placed on hold until the legal description is provided. This will delay the turn around time for the title commitment and closing.
Select all that apply: *

Special Assessment Plat Drawing Priority Pictures Early Start Approval Manufactured Home Endorsement (Alta 7) Closing Protection Letter Wiring Instructions Other
Current Mortgage Information (required for refinances)
Lender
Loan/Account #
Customer Service #
Lender
Loan/Account #
Customer Service #
Lender Information
Loan Amount *
Loan Number *
Loan Officer *
Email *
example@example.com
Phone Number *

Area Code Phone Number
Processor *
Phone Number *

Area Code Phone Number
Email *
example@example.com
Address of Proposed Insured *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Should be Empty: