Title Request

Title Experts, LLC

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		TitleExperts LLC P.O. Box 97 313 DeWitt St. Portage WI 53901 Phone (608)745-0203 Fax (608)745-0204 Watts (866)863-6600 E-Mail

Order Title Online

Order Title Online
Please complete the following form as thoroughly as possible. The more information you supply the better. Click on Submit below to place your order. You can also download or print out a copy of the form and FAX it to our office @ 608) 745-0204. Click Here To Download and Print a copy of this form. * = Required
Your Full Name*
Company Name (if applicable)
Preferred Method of Contact	Email Phone Fax Mail If you would like to be contacted by phone in addition to the method above, please mark the appropriate check box at the bottom of this form.
Address*
City*
State*
Zip Code*
Email Address*
Telephone*
Fax Number
Date Needed (MM/DD/YYYY)* (or estimation)
Request Type*	Title Insurance Owner Policy Loan/Mortgage Policy Letter Report Closing Statement
Loan Amount*
Second Loan Amount
Refinance Only	Yes No
Lender/Loan Information:
(if request is Loan Policy or Refinance)


Lender
Attn
Phone
Fax
Email
Endorsements Requested
Property Information:
Property Address
City
State
County
Type of Property
Tax I.D. Number (if known)
Partial Legal
Present Lender (if applicable)
Loan Number
Buyer/Borrower Information:
Buyer/Borrower (1):
Legal Name
Married	Yes No
Phone
Address
City
State
Zip Code
Buyer/Borrower (2):
Legal Name
Married	Yes No
Phone
Address
City
State
Zip Code
Seller Information:
Seller (1):
Legal Name
Phone
Address
City
State
Zip Code
Seller (2):
Legal Name
Phone
Address
City
State
Zip Code
Purchase Information:
If a purchase:
Offer to Purchase available	Yes No If yes, please submit as soon as possible
Sales Price*
Earnest*
Prior Title or Abstract Title	Yes No If yes, please submit as soon as possible
Seller's Homestead	Yes No
Closing Information:

Closing Date (MM/DD/YYYY)* (or estimation)
Location of Closing
Additional Comments
	I would like a representative of Title Experts LLC to contact me to confirm my order.

**Due to Federal Regulations regarding privacy, you may need to send or give Title Experts, LLC written authorization to request and receive any mortgage payoffs.