Title Insurance and Closing Order Form

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Title Research, Inc.
1 Clyde Road,
Somerset, NJ 08873
Phone#: 1-800-819-0087
Fax#:     1-800-814-8387


                                                           
Client Information Date : _____________________
Name : ___________________________________ Client FILE# : ______________________________
Firm : ____________________________________ Phone : ___________________________________
Address : ________________________________ Fax : _____________________________________
City : ____________ State:__________  Zip_______
Email:_____________________________________


The following Order is for
 (  ) Purchase  (  ) Refinance - Primary Residence
 (  ) Search Only  (  ) Refinance - Investment Property


Purchaser/Owner Information
Name _____________________________________________________________  (  ) Single
 (  ) Husband and Wife
 (  ) Married
E-Mail _____________________________________________________________
Co-Borrower Name and Social Security No.____________________________________________________
Contact Numbers __________________________________________________________________________


Property Information
Seller/Owner_________________________________________  (  ) Single
 (  ) Husband and Wife
 (  ) Married
Address ___________________________________________________________________________________
Municipality _________________________________ Development Name __________________________
County _____________________________________ Lot: _________________ Block:________________

 
New Lender Information Do you want Title Research to send copy to lender ( ) Yes        ( ) No
Mortgage Amount :
Mortgage Clause :
Address:
Address:

Payoff
 ( ) Title Research to Order, Authorization Attached
 ( ) We will provide at a later date


Payoff Lender Information (Fill in Only if Title Research to Order Payoff)
Name Of Lender :__________________________________________________________________________
Mortgage Amount :___________________________   Account Number :____________________________
Name Of Lender :__________________________________________________________________________
Mortgage Amount :___________________________   Account Number :___________________________ 


Back Title Title Research File # : _________________________
 
( ) Attached ( ) To Follow ( ) None Available
Flood Search:
( ) Title Research to Order ( ) Do not Order
SURVEY:
( ) Title Research to Order ( ) To be supplied
( ) Affidavit of no charge ( ) None


Closing Schedule For   Commitment needed by  
       


Special Instructions
 


 

If you are attaching a 1003 Loan application and if any of the above data is on the 1003, then duplication of effort is not required.