Premier Platinum Abstract - Title Order Request

Title Order Request
Purchase or Refinance
PurchaseRefinance
Order Placed By
Full Name*

First NameLast Name
Company Name
E-mail
Phone Number*

Area CodePhone Number
Fax Number

Area CodePhone Number
Property Information
Address of property that is being purchased or refinance
Property Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Buyer Information
How Many Buyers?
Buyer Name*
Buyer Phone Number

Area CodePhone Number
Buyer Email
example@example.com
Buyer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Buyer Marital Status

MarriedNot MarriedDivorced
Buyer #2 Name
Buyer #2 Phone Number

Area CodePhone Number
Buyer #2 Email
example@example.com
Buyer #2 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Buyer #2 Marital Status

MarriedNot MarriedDivorced
Buyer #3 Name
Buyer #3 Phone Number

Area CodePhone Number
Buyer #3 Email
example@example.com
Buyer #3 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Buyer #3 Marital Status

MarriedNot MarriedDivorced
Buyer #4 Name
Buyer #4 Phone Number

Area CodePhone Number
Buyer #4 Email
example@example.com
Buyer #4 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Buyer #4 Marital Status

MarriedNot MarriedDivorced
Seller Information
Seller Name
Seller Phone Number

Area CodePhone Number
Seller Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Seller Mortgage Information
Seller 1st Payoff Lender Company
Seller 1st Loan Account #
Seller 2nd Payoff Lender Company
Seller 2nd Loan Account #
Purchase Price
Sales Agents Information
Selling Agent Name
Selling Agent Phone Number

Area CodePhone Number
Selling Agent Email
example@example.com
Listing Agent Name
Listing Agent Phone Number

Area CodePhone Number
Listing Agent Email
example@example.com
Agreement of Sale
Upload Agreement Of Sale

Upload Documents

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REFINANCE
How Many Borrowers?
Borrower Information
Borrower Name*
Borrower Phone Number

Area CodePhone Number
Borrower Email
example@example.com
Borrower Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Borrower Marital Status

MarriedNot MarriedDivorced
Borrower #2 Name*
Borrower #2 Phone Number

Area CodePhone Number
Borrower #2 Email
example@example.com
Borrower #2 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Borrower #2 Marital Status

MarriedNot MarriedDivorced
Borrower #3 Name*
Borrower #3 Phone Number

Area CodePhone Number
Borrower #3 Email
example@example.com
Borrower #3 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Borrower #3 Marital Status

MarriedNot MarriedDivorced
Borrower #4 Name*
Borrower #4 Phone Number

Area CodePhone Number
Borrower #4 Email
example@example.com
Borrower #4 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Borrower #4 Marital Status

MarriedNot MarriedDivorced
Financing Information
Cash

YesNo
Mortgage Payoff Information
Mortgage Company
Mortgage Loan Officer
Mortgage Phone Number
Mortgage Email Address
Loan Amount
Endorsements Required
If title insurance is required, please check additional endorsements required:

EPL (ALTA 8.1)Survey Coverage (Remove Exceptions)Condominium (ALTA 4)Planned Unit Developement (ALTA 5)Variable Rate (ALTA 6)Comprehensive (ALTA 9)Location (ALTA 22)
Additional Comments
Additional Comments:
Documents
Documents to be:

MailedFaxedE-mailedDropped OffUploadedNo Documents
Upload Documents

Upload

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