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Glossary
New Purchase / Sale Title Request Form
NOTE: Fields marked with
*
are REQUIRED!
Title Search information
Company:
*
Date Ordered:
*
Need by:
*
Ordered By:
*
Office Phone:
*
Return Fax#:
Email:
*
Property Address:
*
Brief Legal Description:
Parcel ID:
*
County:
*
Interested Parties
Purchaser/Borrower(s):
SSN(s):
Additional Borrower:
SSN #:
Home / Cell #:
Work #:
Seller(s):
SSN(s):
Additional Seller:
SSN #:
Home / Cell #:
Work #:
Mortgage Information
Primary Mortgage
Lender (1):
Sale Price:
*
Loan Amount:
Account #:
Contact:
Phone #:
Add Secondary Mortgage...
Secondary Mortgage
Lender (2):
Loan Amount:
Account #:
Contact:
Phone #:
NOTICE!
*If you are requesting Regency Title & Closing, LLC to order payoffs of mortgages please provide a signed authorization form with SSN along with the mortgage account numbers. This will ensure that there are no delays at closing.
Closing Information
Estimated Closing Date:
Will Regency Title be closing this loan?:
Yes
No
Attorney/Firm:
Contact:
Address:
Phone:
Fax Number:
Special Instructions:
