Garden Home Title — Request For Title Insurance Form

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Request For Title Insurance Form

DIRECTIONS: Please complete this form as thoroughly as possible. We have made this form so that you can type directly on the lines and proceed from line-to-line using the Tab key on your keyboard. Any fields that are marked with a star, (*) are required in order for us to properly begin processing this order. Thank you.

A. Order Information:
Loan Officer:
Company Name:
Loan Officer Email Address:*
Loan Officer Phone Number:*
Loan Officer Fax Number:

Processor:
Company Name:
Processor Email Address:
Processor Phone Number:
Processor Fax Number:

Target Closing Day:
Purpose of Loan:
My GHT Rep is:

B. Property Information:
Property Address:*
City:*
State:*	ZIP:*
County:	Tax Folio #:
Subdivision/Condominiom Name
H.O.A.	H.O.A.#:
First Mortgage Holder:	Acct#:
Second Mortgage Holder:	Acct#:

C. Buyer / Borrower Information:
Name of Borrower:
Borrower Email Address:
Borrower Phone Number:
Name of Co-Borrower:
Co-Borrower Email Address:
Co-Borrower Phone Number:
Marital Status:
New Lender:
Mortgagee Clause:
Name:
Address:
24 month chain of title:	Yes No
New Loan Amount $:
Purchase Amount $: (not for refi):
Best form of contact with borrower (only if approved by Loan officer):

D. Seller Information: Leave this Section Blank if this is a Refinance Transaction
Name of Seller:
Name of Co-Seller:
Marital Status:
Seller's Agent:
Seller's Agent Phone:
Buyer's Agent:
Buyer's Agent Phone:

E. Additional Information:
Additional Comments:

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Garden Home Title, LLC • 490 Sawgrass Corporate Parkway, Suite 330 • Sunrise, FL 33325
10151 Deerwood Park Boulevard • Building 200, Suite 250 • Jacksonville, Florida 32256
877-846-2455 • p 954.851.1GHT (1448) • f 954.851.1447
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