Type of Property (check all that apply):

I have searched (or caused to be searched) and examined, the title to the above referenced premises

and request that a title insurance commitment covering said premises be issued, agreeing to insure the interests of the buyer(s) and/or mortgagee(s) in the transaction described below:

TAXES AND ASSESSMENTS (Including Homeowner’s Association/Condo Dues)

OPEN LIENS OF RECORD

(Mortgages, judgments, etc.; if not being paid at or prior to settlement, provide separate communication to ALAS).

RIGHTS OF WAY, EASEMENTS, COVENANTS, CONDITIONS, RESTRICTIONS, SUBDIVISION PLANS, ETC., OF RECORD

(If necessary, provide separate communication to ALAS).

OTHER LIENS, OBJECTIONS, DEFECTS (Lis pendens, suits, etc.)

Application is hereby made for a Title Insurance Commitment covering the above-described transaction. I hereby certify that:

A)  The information contained herein is true and that no material information is being withheld;

B)  I have personally searched all public records affecting tittle to the premises; or examined an abstract purporting to reflect the contents of all such records, completed by an abstractor with Errors and Omission insurance;

C)  In my opinion, the matters set forth herein completely and accurately reflect the status of title to the premises as of the date and time the title search was completed;

D)  I am not aware of any dispute among attorneys of the local bar as to the validity of the title to said premises; and

E)  Title is in no way dependent upon the sale of the property for delinquent taxes or assessments.