Pacific Northwest Title | Title / Escrow Order Form

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Title / Escrow Order

Owners Amount:	$	Escrow Services Requested: Yes No	Date/Time:
ALTA Amount:	$	Escrow Officer:	Taken by:
STD/2nd Amount:	$	Est. Closing Date:	DUE BY:
Other:	$	Marketing Rep:	Prior No:
Property Information

Legal:		Plat:
		Recording District:


Street:		City:		Zip:


Seller:
	Last	First	MI	Last	First	MI
Buyer Borrower:
	Last	First	MI	Last	First	MI

Customer Information

Lender:

Phone:

Fax:

ATTN:

Email:

Street:

City/State:

Zip:

Loan No:

24mo Chain of Title

Add'l Delivery Opts: Email / Fax ONLY, do not send hard copy Prelim only Prelim with hardcopy to follow

Other:

Phone:

Fax:

ATTN:

Email:

Street:

City/State:

Zip:

Add'l Delivery Opts: Email / Fax ONLY, do not send hard copy Prelim only Prelim with hardcopy to follow

List Office:

Phone:

Fax:

Licensee:

Email:

Street:

City/State:

Zip:

Sell Office:

Phone:

Fax:

Licensee:

Email:

Street:

City/State:

Zip:

Title / Prelim Instructions & Payoff Info

Order placed by: Listing Selling Lender Other

Contact Email

Lender Proposed Insured:

ISAOA ATIMA

Customer Reference:

Misc.Inst:

Payoff Information: