Quick Form Title Order

QUICK FORM
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Collier Title Department

Please fill out the form below. After you have completed the form, be sure
to click the "SUBMIT" button located at the bottom of the page.

Contact Email Address:

Date Ordered:

Lending Institution:

Loan Officer:

Lending Inst. Phone #:

Lending Fax:

Need by Date:

Closing Date:

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Do you want Title Insurance? Yes No

Insured By Kentucky Title Center/Investors Title? Yes No
Insured By Title Center of Greater Kentucky? Yes No

Closing: Yes No (If Yes, click appropriate closing type)

Closing Office:

FHA

CONV

KHC

BANK LEVEL

Buyer/Borrower:
Full Name(s)

Marital Status:
(VERY IMPORTANT)

Street Address:

Phone #:

Seller:
Full Name(s)

Marital Status:
(VERY IMPORTANT)

Street Address:

Phone #:

PLEASE NOTE MARITAL STATUS OF BOTH BORROWER & SELLER IS VERY IMPORTANT!!

Full Property Address:

Legal Description:

New Construction: Yes No

Order Survey Yes No

Deed Book:	Page:	County:
Payoff To: Payoff Account Number(s):
Loan Amount: (VERY IMPORTANT)
Future Advance: (VERY IMPORTANT)
Intended Lien Position: (VERY IMPORTANT)
Sales Price:
Prepare Deed: Yes No
Prepare Mortgage: Yes No
Prepare Exhibit: Yes No
Mortgage Type: (Regular/HEQ, Etc.)

Is there a manufactured home involved with this transaction?: Yes No (VERY IMPORTANT)

Give Description :

Is any seller recently deceased, divorced or remarried?: Yes No (VERY IMPORTANT)

Please Explain:

Loan Fees or Additional Comments: Yes No

Click the "SUBMIT" button to the right to send your title order and generate a receipt