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Our Role

Order Title Insurance

Application for Title Insurance:
New Construction/Contract Home

This application is for lending institutions or land owners to complete for a new construction project where a contract is executed between the said Owners of the vacant land and a Builder/General Contractor.

To ensure a prompt response, please make sure you fill out as many of the listed fields as possible. Your information will be kept confidential. We won’t sell, trade, or lease your information to anyone.

May we suggest that an “Authorization to Release Confidential Information” be submitted via fax or mail with this application. This form enables us to order payoffs and retrieve information for the closing.

*Name:
*Email:
Property or Street Address:
*Tax Key Number
*Owner:
Current Address:
*Contract Price:
(Please fax copy of construction contract to Assurance Title at 920-235-2122.)
*Builder/General Contractor:
Builder's Address:

*Lender:

Loan Officer:
*Lender's Address:
*Phone:
Fax:
*Loan Amount:
Loan Type:
Requested Endorsements:
Proposed Insured:  Same     To read as follows:
Anticipated Closing Date:
Legal Description:
Property Type: (Vacant)  Residential
 Commercial
Prior Title Evidence:

 Pickup Abstract at:  or
I'll fax a copy of the old title insurance

Conditions of Title Known:
(Shared driveway, shared well, easements.)
Special Instructions:  Order City Letter
 Provide Current Tax Print-out
*Ordered By/Name & Co:
*Required Fields  

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