Land Title Guaranty - Sioux Falls, South Dakota

Title Insurance Order Form

This form needs will be attached to a file number after the order and the information must be
kept on this system.

Date of Title Order:
Lender:		Sales Price:
Estimated Closing Date:
Ordered By:		Loan Amount:
Name:		Loan Type:

Company		Type of Policy: (Check one or both and extended coverage if needed) Lenders Lenders Extended Coverage Owners Owners Extended Coverage
Address:		Phone:
Fax:		2nd Mortgage?
Email:		$75 Letter Report? $150 Letter Report?
Rush Order?		Is Land Title closing the transaction?

Legal Description:
Property Address:
Property Type:	Residential Commercial Bare Land

Seller(s) Names and SSN:
Seller 1:		SSN:
Seller 2:		SSN:
Address:
City:		State:	Zip Code:

Listing Agent:		Selling Agent:
Phone:		Phone:
Fax:		Fax:
Email:		Email:
Customer Notes:
Security Code