Please fill out the form below to submit a title request.

* - required fields
 
MORTGAGE COMPANY INFORMATION

Leave this empty:

     
*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 from our instant prehud calculator, if you do not have an ID, 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
Rachel Ayers
Not Sure		 Mark Cunningham
Steven Lenet
Rachel Palmisano
 Steve Potler
Tasha Himes
Jennifer Kehs
Other:
Any additional information we should know?
Attachment:

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