Fillable TITLE ORDER REQUEST

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TITLE ORDER REQUEST

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TITLE ORDER REQUEST
Burnt Store Title & Escrow
Date Ordered:
Attn: Jennifer Bollinger
Ordered By:
Phone: (941)205-3400
Phone:
Fax: (941)205-3402
Email:
Email: Jenn@burntstoretitle.com
Purchase Price: $____________________________ Closing Date:__________________________________
Escrow Deposit Amount $_____________________ Loan Amount:$________________________________
PROPERTY INFORMATION
Property Address:
Parcel ID #
Legal Description
SELLERS INFORMATION
Name:
Address
Phone:
Marital Status
Phone 2:
Email:
Will Sellers Attend the Closing?
Does Seller have a current Survey?
IS/ARE SELLER(S) UNITED STATES CITIZEN(S)?
BUYERS INFORMATION
Name:
Address
Phone:
Marital Status
Email:
Will Buyer Attend the Closing?
Would Buyer Like us to Order a Survey?
LISTING AGENT
Company:
Listing Agent:
Phone:
Fax:
Email:
Commission
Transaction Fee
SELLING AGENT
Company:
Phone:
Fax:
Email:
Commission
Transaction Fee
NEW LENDER INFORMATION
Company:
Contact
Phone:
Fax:
Email:
New Loan
Amount
Is there a Homeowners Association? ______________
Association Name: ____________________________________________________
Dues Paid: In the amount of $_____________________
**Please note that we must be notified if seller is not a US Citizen**
SPECIAL INSTRUCTIONS:
Selling
Agent:
Burnt Store Title & Escrow
150 Laishley Ct.
Suite 122
Punta Gorda, FL 33950
Ph:(941)205-3400 Fx: (941)205-3402
Email: Service@burntstoretitle.com
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TITLE ORDER REQUEST

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Completed 15 March 2021

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