Date of Order: Closing InformationCounty(Required)Please select a countyBurleigh CountyMorton CountyStutsman CountyOtherClosing Officer(Required)No PreferenceHailey - BismarckJade - BismarckAmber - BismarckLynzee - JamestownTransaction Type(Required)PurchaseRefinanceConstruction LoanPermanent FinancingMobile HomeContract for DeedCash PurchaseTitle OnlyDate Needed(Required) MM slash DD slash YYYY Estimated Closing Date(Required) MM slash DD slash YYYY Title Service(Required)Title Insurance and ClosingAbstract Update and ClosingAbstract Update, Title Insurance and ClosingAbstract Update and Title InsuranceClosing OnlyTitle Insurance OnlyAbstract Update OnlyConstruction Policy or BinderAbstract Update, w/ Second Update and Title OpinionTitle Report - Owner and EncumbranceIs a final Ownership and Encumbrance report needed? Yes No How would you like your documents delivered?: Email Faxed Hard Copy (Original) Email Address Fax NumberDelivery Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Ordered ByOrdered by Company Name(Required) Company Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneFax NumberEmail Address(Required) Loan InformationLoan Officer Lender's Reference/Loan # Estimated Property Value(Required)Sale Price $(Required)Loan Amount(Required)Abstract Continuation Yes No Current location of abstract Is there a 1031 Exchange involved? Yes No Loan Type Will there be a second Mortgage closing simultaneously? Yes No Type DECA Loan Start Loan Equity Line Owner's Policy Yes No Lender's Policy Yes No Endorsements EPA Condo Variable Location Comprehensive PUD Other Other Endorsement Proposed Insured Lender Property InformationManufactured Home(Required) Yes No Please provide VIN (if known) Legal DescriptionProperty Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Property is Existing New Construction Vacant Lot Property TypeResidentialCommercialPresent Owner(s) / Seller(s)Name First Last PhoneEmail Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Marital Status Mortgage InformationMortgage Company Loan Number Approx. Balance Mortgage Company 2 Loan Number 2 Approx. Balance 2 Listing Realtor Selling Realtor Purchaser(s)Purchasers Name(Required) First Last Purchasers PhonePurchasers E-mail Purchasers Current Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Other Comments / Special InstuctionsWill there be a power of attorney used by any of the parties?(Required) Yes No If yes, please adviseAre any of the current owners deceased?(Required) Yes No If Yes, Names: Are any of the parties divorcing?(Required) Yes No If yes, Enter Names Location Drawing(Required) Yes No Deed Preparation(Required) Yes No If yes, Type Individual Tenants in Common Joint Tenancy Mineral Reservation Comments / Special InstructionsUpload Document (1)Accepted file types: doc, docx, pdf, txt, Max. file size: 8 MB.Upload Document (2):Accepted file types: doc, docx, pdf, txt, Max. file size: 8 MB.Upload Document (3):Accepted file types: doc, docx, pdf, txt, Max. file size: 8 MB.TRID(Required) Yes No Homes for Hero’s?(Required) Yes No If yes, enter occupation:(Required) Legal Information In accordance with the Gramm-Leach-Bliley Act, Quality Title, Inc. recommends that you review the privacy policy prior to submitting any information on the above order form. By submitting this order form, you are indicating that you have read and agree to the terms in the Privacy Policy statement.EmailThis field is for validation purposes and should be left unchanged.
