ONLINE ORDER for Title Insurance ORDER FOR TITLE INSURANCE * Denotes Required Field If you desire to clear this form and start again, use this button: Please answer all questions Do not press Enter at anytime before you are completed filling out the form. If you submit the form before the information is complete, please use your back button, finish the form, and re-submit. Names, amounts, legal descriptions, etc., must be shown EXACTLY as they are to appear on the commitment. OWNER'S POLICY AMOUNT: $ PROPOSED INSURED: Joint Tenants Tenant in Common Other Single Married - SPOUSE'S NAME: LENDER'S POLICY AMOUNT: $ PROPOSED INSURED: ASSIGNEE OF MORTGAGE, IF ANY: SURVEY SURVEY ORDERED BY: ON (DATE): SURVEY NOT REQUIRED (PLEASE SKIP TO CLOSING) (We will need a copy of the survey and purchase agreement sent to this office with a note attached that your order was placed on the web). CLOSING WILL THE CLARK TITLE COMPANY BE DOING THE CLOSING? YES NO APPROXIMATE CLOSING DATE NEED BY TYPE OF CLOSING: REFINANCE PURCHASE ASSUMPTION WILL THE BUYER BE LIVING ON THE PREMISES? YES NO PROPERTY ADDRESS OF INSURED PROPERTY: BUYER/BORROWER MAILING ADDRESS: LEGAL DESCRIPTION: SELLERS NAME & MAILING ADDRESS: RESIDENTIAL YES NO • MOBILE HOME YES NO • DUPLEX YES NO • CONDO YES NO • APARTMENT HOUSE YES NO MAIN RESIDENCE YES NO COMMERCIAL YES NO BARE LOT YES NO FARMLAND YES NO TITLE IS NOW VESTED IN: ARE THERE ANY UNRECORDED CONTRACTS? YES NO IF YES, A COPY WILL NEED TO BE PROVIDED DOES THIS TRANSACTION INVOLVE CONSTRUCTION? YES NO IF YES, NAME OF GENERAL CONTRACTOR HAS CONSTRUCTION BEEN STARTED? YES NO IS CLARK TITLE TO HANDLE LOAN DISBURSEMENT? YES NO ANY IMPROVEMENTS OR REPAIRS? YES NO (within the last 6 months) FINANCING 6 (ARM) 8.1 (EPA) ENDO-100 SPECIAL ENDORSEMENTS OTHER Mail Deliver Fax Bill Copy Original Lender Name Address Listing Agent Name Address Selling Agent Name Address Attorney Name Address Attorney Name Address Other Name Address COMMENTS ORDER INFORMATION * Ordered By: Company Name: Contact Person: * Phone: Fax: * E-Mail: * Billing Address: * City: * State: * Zip: (If you need to clear the form and begin again, please return to the top for instructions)
ONLINE ORDER for Title Insurance
ORDER FOR TITLE INSURANCE
* Denotes Required Field If you desire to clear this form and start again, use this button:
* Denotes Required Field
If you desire to clear this form and start again, use this button:
Please answer all questions Do not press Enter at anytime before you are completed filling out the form. If you submit the form before the information is complete, please use your back button, finish the form, and re-submit. Names, amounts, legal descriptions, etc., must be shown EXACTLY as they are to appear on the commitment.
Please answer all questions
Do not press Enter at anytime before you are completed filling out the form. If you submit the form before the information is complete, please use your back button, finish the form, and re-submit.
Names, amounts, legal descriptions, etc., must be shown EXACTLY as they are to appear on the commitment.
OWNER'S POLICY AMOUNT: $ PROPOSED INSURED: Joint Tenants Tenant in Common Other
Single Married - SPOUSE'S NAME:
LENDER'S POLICY AMOUNT: $ PROPOSED INSURED: ASSIGNEE OF MORTGAGE, IF ANY:
SURVEY
SURVEY ORDERED BY: ON (DATE):
SURVEY NOT REQUIRED (PLEASE SKIP TO CLOSING)
(We will need a copy of the survey and purchase agreement sent to this office with a note attached that your order was placed on the web).
CLOSING
WILL THE CLARK TITLE COMPANY BE DOING THE CLOSING? YES NO
APPROXIMATE CLOSING DATE NEED BY
TYPE OF CLOSING: REFINANCE PURCHASE ASSUMPTION
WILL THE BUYER BE LIVING ON THE PREMISES? YES NO
PROPERTY
ADDRESS OF INSURED PROPERTY: BUYER/BORROWER MAILING ADDRESS:
LEGAL DESCRIPTION: SELLERS NAME & MAILING ADDRESS:
TITLE IS NOW VESTED IN:
ARE THERE ANY UNRECORDED CONTRACTS? YES NO IF YES, A COPY WILL NEED TO BE PROVIDED
DOES THIS TRANSACTION INVOLVE CONSTRUCTION? YES NO IF YES, NAME OF GENERAL CONTRACTOR
HAS CONSTRUCTION BEEN STARTED? YES NO
IS CLARK TITLE TO HANDLE LOAN DISBURSEMENT? YES NO
ANY IMPROVEMENTS OR REPAIRS? YES NO (within the last 6 months)
FINANCING
6 (ARM) 8.1 (EPA) ENDO-100 SPECIAL ENDORSEMENTS OTHER
Lender Name Address
Listing Agent Name Address
Selling Agent Name Address
Attorney Name Address
Other Name Address
COMMENTS
ORDER INFORMATION
* Ordered By: Company Name: Contact Person: * Phone: Fax: * E-Mail: * Billing Address: * City: * State: * Zip:
(If you need to clear the form and begin again, please return to the top for instructions)