Welcome to Community Title, LLC : Order

To order title insurance online from Community Title, fill out this quick application as completely as possible. Upon submission you will be contacted and informed of any additional documents that may be required. If any answers in the form below require further explanation, please use the comments section at the end of this form.

*Required fields

Customer

*Name:

Company:

*Email:

Phone:

Fax:

Closing Information

*Transaction Type:

*Purchase Price:

Loan Amount:

Est. Closing Date:

Property

*Street Address:

County:

*City:

Parcel ID:

*Florida ZIP:

Legal Description:

Buyer/Borrower

*Borrower's Name:

*Borrower's fax no.:

*Co-Borrower's Name:

*Co-Borrower's fax no.:

*Borrower's email:

*Co-Borrower's email:

*Marital Status:

*Borrower's Phone:

*Occupany Status:

Agent:

*Borrower's Address:

Agent Phone:

*City:

Deposit Held By:

*State:

*ZIP:

Deposit Amount:

Seller (leave blank if refinancing)

*Seller's Name:

*Seller's fax no.:

*Co-Seller's Name:

*Co-Seller's fax no.:

*Seller's email:

*Co-Seller's email:

*Marital Status:

*Seller's Phone:

*Seller's Address:

*City:

Agent:

*State:

*ZIP:

Agent Phone:

Lender

*Lender:

Loan Officer's Name:

Officer's Phone:

Lender's fax no.:

Lender's email:

Additional Information

First Mortgage Co:

Second Mortgage Co:

First Loan #:

Second Loan #:

First Mortgage Phone:

Second Mortgage Phone:

Survey:

Hazard Insurance:

Needed

Not Needed

Termite Inspection:

Hazard Ins. Phone:

Needed

Not Needed

Association:

Association Phone:

Yes

Comments: