Title Company of America Order Entry To send in an order, fill out the form below. Processing will begin promptly. Thank you.

Step 1, Tell us about yourself:
Your Name:	[REQUIRED]
Your Company:	[REQUIRED]
Phone Number: example (5551119999)	[REQUIRED]
Your Facsimile Number: example (5551118888)
Your Email Address:	[REQUIRED]
Name of Loan Officer:
Name of Loan Processor:

Step 2, Tell us about the financial transaction:
Type of Transaction:	Make Selection Construction Loan Refinance Sale / Purchase Second Mortgage Section 1031 Exchange  [REQUIRED]
Selling Price or Value:	(Only required for purchases)
Mortgage Amount:	[REQUIRED]
Target Closing Date:

Step 3, Tell us about the Property: [All items REQUIRED in Step 3, except PIN #]
Underlying Property:	Make Selection Single lot Multiple lots Not Sure
Address:
City:	State:  Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Zip Code:
County:
PIN#:
Is the Property owner-occupied?	Yes No

Step 4, If this is Commercial Property: (If 1-4 family owner-occupied residence, click here)
Use of structure(s):	Make Selection Office / Retail Industrial Condominium (Single Unit) 1 to 4 Family Residential Multifamily (5 or more units) Other use
If "Other Use," please describe the current use :
Est. sq. footage:	Number of stories:
Status of structure(s):	Make Selection Existing Structure New Construction Vacant Land Other Use
If "Change of Use," please describe the proposed use:
Step 4, Tell us what commercial endorsements you will need? (Check all that apply.) EPA Location Zoning Comprehensive ARM Survey Usury Tax Parcel DBA Fairway Option Manufactured Housing PUD Utility Access Contiguity Creditor Rights Revolving Credit Pending Disbursement Other

Step 5, Tell us about the Borrower (Buyer):
Borrower's Name:  [REQUIRED]	Social Security Number: example (111550000)
Co-Borrower’s Name:	Social Security Number: example (111550000)
Note: List additional Borrowers in Step 8 at the bottom of this form.
Borrower’s Attorney's Name:
Borrower’s Attorney's Phone: example (5551119999)
Borrower’s Attorney’s Facsimile: example (5551119999)
Borrower’s Attorney’s Email Address:

Step 6, Tell us about the Seller (if refinance, click here)
Seller's Name:	Social Security Number: example (111550000)
Co-Seller's Name:	Social Security Number: example (111550000)
Note: List additional Sellers in Step 8 at the bottom of this form.
Seller's Attorney's Name:
Seller's Attorney's Phone: example (5551119999)
Seller's Attorney’s Facsimile: example (5551119999)
Seller's Attorney’s Email Address:

Step 7, Tell us about the Lender:
Lender's Name:
Lender’s Contact’s Name:
Lender’s Contact’s Phone example (5551119999)
Lender’s Contact’s Facsimile: example (5551119999)
Lender’s Contact’s Email Address:

Step 8, Please enter any special instructions, comments or information:

  

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