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707 Shelden Avenue
Houghton, Michigan 49931

(906) 482-7903 [t]
(906) 482-7977 [f]

Hours:
Monday - Friday
8:30 AM to 4:30 PM
 

 

Order Insurance
 
Fields marked with an asterisk (*) are required. Thank you.

NOTE:
You must enter the verification code at the bottom of this form in order for your submission to be processed.
 

Date Ordered:

Date Needed:
Your File/Loan Number:
 
POLICY TYPE:
 
Owner's Policy: Mortgage Policy:
$
   
TYPE OF LOAN
This field is required if a mortgage policy is
being requested.
Transaction:
Would you like us to conduct the closing?
Yes - >>>>>>>>>>>>>>>>>>>>>>>>> Would you like us to order the deed/documents?
Yes No
No If Yes, please provide Attorney Preference:
 
Reminder: Please provide addresses of parties and indicate how title will be held.
 
BUYER(S) OR MORTGAGOR(S):
 
Name(s):
Street Number & Name:
City & State: Zip Code:
Husband and Wife
Joint tenants w/Full Right of Survivorship (JT W/FROS)
Tenants in Common
Other - Please identify in Additional Instructions below
LENDING INSTITUTION:
Lender: (as name should appear on title policy)
SELLERS:
 
Name(s):
Street Number & Name:
City & State: Zip Code:
 
LEGAL DESCRIPTION OF REAL ESTATE:
Tax Identification Number of Real Estate:
County:
Township/Village:
Described As:
STREET ADDRESS OF REAL ESTATE:
Street Number & Name:
City & State: Zip Code:
CHARGE AND DELIVER TO:
Company Name:*
Attention:
Street Number & Name:
City & State: Zip Code:
Phone:  
 
E-mail:
Additional Copies To:
Additional Instructions:
 
Verification*
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