Order Form

Please fill the form out as completely as possible.

       * = Required fields


Please provide the following contact information:
 
 
*NameCompany
*Address*FAX
*PhoneEmail

Type of transaction and endorsements:
  Standard (100, 116, 8.1)
None
100
116
8.1
Variable
Other
Revolving

Proposed insurance amounts:
 
 
Loan Amount? Sales Price? Prior Order #?

Seller(s)/Owner(s)
 
Last Name
First Name
Middle
Phone#
SS#

Buyer(s)/Borrower(s)
 
Last Name
First Name
Middle
Phone#
SS#

Property info:
 
 Address: Tax Serial No:

Legal description:
 
 

Will you close in our offices?
 
  Yes - Provo Yes - Spanish Fork No

Lender

 

Realtors

More info:   More info:
Escrow Info
 
 
Pay-off Loan#
Loan seviced by
Address/Phone
 
 
Lender:
Officer:
Processor:
Phone:
Fax:

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Realtors:
 
 
Listing:
Company:
Phone:
Fax:
%Commission:
 
Selling:
Company:
Phone:
Fax:
%Commission:

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Would you like to request a mini-escrow?
(Please be aware that there is a $75.00 mini-escrow fee for this service if we are not closing this loan in one of our offices.)
 
  Yes No
Additional comments or instructions:
 
 


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Pro-Title and Escrow Inc.
  All rights reserved.