Title and Escrow Residential

This form is designed to begin the Title order process for anyone wishing to use Guardian Title for a transaction.

* Indicates a required field

Personal Information
First Name: *	Last Name: *
Company:
Address:
City:	State:	Zip:
Phone: * () -	Fax: () -
E-Mail:

Property Information
Seller: *
Street No.: *	Street: *
City: *	County: *
PPN:
Subdivision:
Sub Lot No.:
Buyers Name:
Additional Property Information

Services Requested ( Lenders )
Exam	Special Tax Search	Mortgage Location Survey
Flood Certification	Commitment	ALTA Loan Policy
ALTA Owner's Policy	Title Guaranty	Escrow

Commitment/Policy Information ( Lenders )
Owner's Policy Amount:	Lender Name:	Lender's Policy Amount:
EPA Endorsement (ALTA Form 8.1)
Comprehensive Endorsement (ALTA Form 9.0)
Variable Rate Endorsement (ALTA Form 6.1)
Other
Standard Exceptions are to be deleted from policy
Other Requirements
Anticipated Settlement Date:

Send Original Commitment to:
Person placing order
Other Person
First Name: *	Last Name: *
Company:
Address:
City:	State:	Zip:
Phone: * () -	Fax: () -
E-Mail:
If you would like copies of the commitment provided to others please provide their Name, Company, Address and Phone Number.

Your preferred way to receive the information requested? *

E-Mail Fax Messenger Service Overnight Delivery U.S. Mail

We will make every effort to deliver your request in the manner you prefer. However, due to factors outside our control we can not guarantee all information needed to complete your order can be sent via e-mail or fax. In instances where everything can not be delivered via e-mail or fax we will send the information via U.S. Mail unless you have indicated "Messenger Service" or "Overnight Delivery." There will be an additional charge for Messenger Service or Overnight Delivery.