Title and Escrow Services Throughout Michigan and Illinois

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Property Address

City

Michigan County

Illinois County

Current Owner/Seller Name

Social Security Number

Legal Description

Tax ID Number

Type of Transaction
 Cash Sale

 Sale with New Mortgage

 Foreclosure

 Land Contract

 Refinance

 Equity Loan / Second Mortgage

 Title Search

Is this a short sale transaction?
 No

 Yes

Insured’s Name / Purchaser

Sales Price / Owner’s Policy Amount

Lender (if new mortgage)

Name

Attention

Address

City

State

Phone

Fax

Mortgage Amount

Previous Policy for Credit
 No

 Yes

Ordered By

Client Name

Attention

Address

City

State

Phone

Fax

Your Case Number

Special Instructions

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