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Order Form

Date: Need By: Ordered By: At: Phone No: Fax No:

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Title Insurance
Letter Report
Deed & Transfer Return
Realtor/Sellers Closing Statement
Update (Preliminary or Final )
Title Opinion (Preliminary or Final )
Other

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Complete this section if ordering a closing statement:

Commission: (% or $ )
Estimated Closing Date:
American Title to do Closing? Yes or No
Who is paying for closing statement? Seller or Realtor

If we are doing a closing statement, please attach a copy of Data Sheet, Offer to Purchase, Counter Offers, Amendments and Listing Contract.

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Property Address: City: County: Seller(s)/Owner(s) Name(s): Buyer(s) Name(s): Lender: At: Ph: Listing Realtor: At: Ph: Selling Realtor: At: Ph:

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Complete this section if ordering Title Insurance:

Owner's Policy for $
Lender's Policy for $

Purpose:
Purchase
Refinance
Construction
Second Mortgage

Endorsements:
Comp.
Location
Environmental
ARM

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Is prior title evidence available? Yes No
If yes, please indicate which type: Title Policy Abstract
American Title's Previous Policy #

Comments: