Advantage Title Company

Please fill out the form below to submit a title request.
* - required fields

MORTGAGE COMPANY INFORMATION
*Company Name:		*Phone Number:
Loan Officer:
*Processor's Name:		*Processor's Phone:
*Processor's Email:		Processor's Fax:

LENDER INFORMATION
Lender:
Mortgagee Clause for ICL:
Lender Processor's Name:		Lender Processor's Phone:

LOAN INFORMATION
*What is your ID No from our instant prehud calculator, if you do not have an ID No enter NA:
Choose One:	Purchase: First-time Homebuyer
	Refinance: Second Home
Loan Number:	*Required by some lenders
*Approximate Loan Amount:
Est. Settlement Date:
Settlement Location:
Should Advantage Title Company request a title survey? Yes No
Is anyone being added or removed from title? Yes No
If yes, please explain:

BORROWER/BUYER INFORMATION
*Borrower/Buyer #1 Name:		*Social Security Number:
Borrower/Buyer #2 Name:		Social Security Number:
*Main Phone:		Other Phone:

SELLER INFORMATION
NOTE: Sellers MUST be on title.
Seller #1 Name:		Social Security Number:
Seller #2 Name:		Social Security Number:

PROPERTY INFORMATION
*Property Address:
*City:		State: Zip Code:
County:

PAYOFF INFORMATION
*Should Advantage Title Company request payoffs? Yes No
1st Name:
Phone Number:
Account Number:
2nd Name:
Phone Number:
Account Number:
Are there any open judgements or tax liens? Yes No
If yes, please explain:

ADDITIONAL INFORMATION
Account Manager:	Christopher Breck Jeff Sussman	Mark Cunningham Marti Mason	Steve Potler Not Sure
	Other:
Any additional information we should know?
Attachment: