Order Online

Applicant Info
Order Requested By:*
Order Date:* 08-28-2008
Estimated Closing Date:*
Need Title Work By:*
Transaction Type*
Please check one:
Purchase
Refinance
Purchase Price*
Mortgage Amount*
2nd Mortgage Amount
Buyer Information
Buyer Name(s)
Buyer 1*

Buyer 2
Marital Status/Years Married
Maiden Name
Buyer's Current Address(es)
Street

Address 2

City/Town
Zip/Post Code
Buyer's Phone #s
Home*
( ) -
Work
( ) -
Buyer's Fax
Buyer's Email
Attorney
Attorney Phone # ( ) -
Attorney Fax # ( ) -
Seller Information
Seller Name(s)
Seller 1

Seller 2
Marital Status/Years Married
Maiden Name
Seller's Current Address(es)
Street

Address 2

City/Town
Zip/Post Code
Seller's Phone #s
Cell
( ) -
Work
( ) -
Other
( ) -
Seller's Fax ( ) -
Seller's Email
Seller over 62?
Seller attending settlement?
Attorney
Attorney Phone # ( ) -
Attorney Fax # ( ) -
Property Information
Street Address
City/Town*
County*
Tax Map Block(s)*
Lot(s)*
Please check one:* Owner Occupied
Owner Unoccupied
Vacant
Prior Title Policy Available?
Lender Information
Lender Name
Lender Contact Person
Lender Contact Number
Cell

Work

Other
Lender Fax ( ) -
Lender Address
Remarks or Special Instructions
Enter them here:
Include Attachments (i.e. Agreement of Sale, Seller Mortgage Payoff Letters, Prior Survey/Deed/Legal Description, Prior Title Insurance Policy, Power of Attorney, etc.)



For your convenience, Regal Title Company can arrange to have any services that you may need completed for your real estate transaction. By filling in the following information, you are authorizing our offices to order any inspections and services on your behalf. Carefully review and complete the following form so that we may assist you further in your settlement process.
I/We hereby authorize the order and delivery of the following: (Please check all that apply)

  • Survey
  • Pest Inspection
  • Well Water Analysis
  • Waste disposal septic System Certification
  • Deed & Affidavit
  • Smoke Detector Inspection Letter
  • Certificate of Occupancy
  • Oil Reading
  • Other 1 :
  • Other 2 :
  • Other 3 :
You are now ready to submit the form