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*

PurchaseTitle lns OnlyRefinanceTitle lns & ClosingNew ConstructionMail Out Closing2nd MortgageJr. Lien Policy
Application Date:*

MonthDayYear
Date
Estimated Closing Date:*

MonthDayYear
Date
Full Name of Borrower #1*

First NameLast Name
Phone Number*

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

First NameLast Name
Phone Number

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

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Property Address*

Street Address

County

CityState / Province

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

YesNoAbstractTorrens
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 AssessmentPlat DrawingPriority PicturesEarly Start ApprovalManufactured Home Endorsement (Alta 7)Closing Protection LetterWiring InstructionsOther
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 CodePhone Number
Processor*
Phone Number*

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

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Should be Empty: