Date
Date Needed
Select a Closer SELECTTo Be DeterminedDebbie BergTara GladKimberly JudgeJennifer LaumeyerSteph PetersonLee SiebenMichelle SmallidgeJackie Tix
Select a Closing Location SELECTTo Be DeterminedApple ValleyEdinaHastingsMendota HeightsMinneapolisRosevilleWoodbury
Anticipated Closing Date
Mortgage Amount
Sale Price
Type of Transaction SELECTCONVVAFHACONSTREHABROLLOVERCASH
Endorsements SELECTNo EndorsementARMBalloonOther
Property Inspection? SELECTYesNo
Does buyer request an owner's policy? SELECTYesNo
Will there be a simultaneous second mortgage? SELECTYesNo
If YES, will a junior policy be needed? SELECTYesNo
Is contract for deed being paid off? SELECTYesNo
Comments and Special Instructions
Policy Ordered MortgageOwner's
Special Assessment Search SELECTYesNo
Mortgagees Plat Drawing SELECTYesNo
Priority Pictures SELECTYesNo
Construction Disbursement SELECTYesNo
Insured Closing Letter SELECTYesNo
Chain of Title Report SELECTYesNo
Number of Months?
Mortgage Policy
Lender's Address
City
State SELECTAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
Zip
Owner's Policy
Contract for Deed Policy SELECTYesNoVendor'sVendee's
Property Address *
City *
County *
State * SELECTMinnesotaWisconsin
Zip *
Tax Number
Legal Description
Property Is SELECTUnknownAbstractTorrens
Certificate Number
Location of Abstract
File Number
Prior Title Evidence SELECTOwner's PolicyAbstractNone (Torrens)Unknown
Property Is SELECTVacant LandExisting BuildingsCommercialResidentialProposed ConstructionRecent Improvements/Repairs
Present Owner(s) *
Home Phone
Work Phone
Email Address
Occupant (If Not Owner)
Buyer's Name(s) *
Buyer's Present Address
Special Instructions
Company Name *
Contact Name *
Address *
State * SELECTAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
Phone Number *
Fax Number
Email Address *
Loan/Reference Number
Listing Agent & Company
Selling Agent & Company
Copies To
Attach Document
For additional attachments, please send files to applicationdept@dcatitle.com.
