Title Insurance Request Form

OWEN TITLE COMPANY, INC., is excited about working with you on the closing of your transaction.

To make this smooth as possible, and to avoid numerous telephone calls, please take just a moment to fill in the following information:

^* Indicates a required field.

^*Send Form To: Please Select A Closing Agent... Debbie Parker George Henderson Julie Glaze Felicia Jenkins Janne Andrews

^*Ordered By:

^*Closing Agent:

^*Date:  

Legal Desription
Lot:
Block:

Metes and Bounds
Legal Attached:  Yes  /> No
Tax ID #:

New Financing:

Lender

Loan officer

Contact Phone

Contact Fax

Loan Amount $ Do not enter Dollar Sign ($) or Thousands separator.

Conventional

FHA

1^st Mortgage To Be Paid Off

Loan Number

2^nd Mortgage To Be Paid Off

Loan Number

City of Tallahassee Energy Loan Number

All Parties To Be At Closing  Yes  No

Please Provide Address Acceptable For Federal Express Delivery, including phone number (no P.O.Boxes)

^*Street Address

^*City

^*State Please Select... Alabama Illinois Montana Colorado Arizona Michigan District of Columbia New Mexico North Dakota Nebraska Kentucky Tennessee Vermont Oklahoma Massachusetts New York Missouri Indiana Hawaii Florida South Carolina Louisiana New Jersey Maine Virginia Iowa Kansas Maryland Georgia Rhode Island Pennsylvania Ohio Texas New Hampshire Delaware Minnesota Utah Alaska Wyoming West Virginia Wisconsin North Carolina Arkansas Connecticut Idaho Mississippi Nevada South Dakota Oregon Washington California

^*Zip Code

^*Phone Number

Real Estate Commission: % >

Split
To Selling Agent: %
To Listing Agent: %

Listing REALTOR^®

Office

Agent

Phone

Fax

Email

Selling REALTOR^®

Office

Agent

Phone

Fax

Email

Surveyor

Company Name

Contact Person

Phone Number

Fee $ Do not enter Dollar Sign ($) or Thousands separator.

Termite Inspection

Company Name

Contact Person

Phone Number

Fee $ Do not enter Dollar Sign ($) or Thousands separator.

Hazard Insurance

Company Name

Contact Person

Phone Number

Fee $ Do not enter Dollar Sign ($) or Thousands separator.

Home Inspection

Company Name

Contact Person

Phone Number

Fee $ Do not enter Dollar Sign ($) or Thousands separator.

Home Warranty

Company Name

Contact Person

Phone Number

Fee $ Do not enter Dollar Sign ($) or Thousands separator.

Homeowners Association

Company Name

Contact Person

Phone Number

Fee $ Do not enter Dollar Sign ($) or Thousands separator.

Repairs/invoices attached/to follow:

Transaction Fees

Buyer $ Do not enter Dollar Sign ($) or Thousands separator.

Seller $ Do not enter Dollar Sign ($) or Thousands separator.