Name * First Name Last Name Date * MM DD YYYY Email * Special Instructions/Additional Information Transaction Type Cash Contract of Sale Exchange New Construction Refinance Resale/Purchase Loan Type Cash Contract of Sale Conventional Insured Conventional Uninsured FHA FMHA VA Sale Price $ Loan Amount $ Do you have documents to submit with this order? (If yes, you will be prompted to send them to customerservice@serviceonetitle.com after submitting this form) * Yes No Property Information Address * Address 1 Address 2 City State/Province Zip/Postal Code Country County * Alcona Alger Allegan Alpena Antrim Arenac Baraga Barry Bay Benzie Berrien Branch Calhoun Cass Charlevoix Cheboygan Chippewa Clare Clinton Crawford Delta Dickinson Eaton Emmet Genesee Gladwin Gogebic Grand Traverse Gratiot Hillsdale Houghton Huron Ingham Ionia Iosco Iron Isabella Jackson Kalamazoo Kalkaska Kent Keweenaw Lake Lapeer Leelanau Lenawee Livingston Luce Mackinac Macomb Manistee Marquette Mason Mecosta Menominee Midland Missaukee Monroe Montcalm Montmorency Muskegon Newaygo Oakland Oceana Ogemaw Ontonagon Osceola Oscoda Otsego Ottawa Presque Isle Roscommon Saginaw St. Clair St. Joseph Sanilac Schoolcraft Shiawassee Tuscola Van Buren Washtenaw Wayne Wexford Legal Description Seller Information Company Name (if applicable) Seller 1 First Name Last Name Seller 2 (if applicable) First Name Last Name Type of Estate Seller's Address Address 1 Address 2 City State/Province Zip/Postal Code Country Seller's Phone Number (###) ### #### Sellers Email Additional Sellers Buyer/Borrower Information Company Name (if applicable) Buyer/Borrower 1 Name First Name Last Name Buyer/Borrower 2 Name First Name Last Name Type of Estate Buyer/Borrower Address Address 1 Address 2 City State/Province Zip/Postal Code Country Buyer/Borrower Phone Number (###) ### #### Buyer/Borrower Phone Email Address Additional Buyers/Borrowers Lender Information Lender Name Contact Name First Name Last Name Lender Address Address 1 Address 2 City State/Province Zip/Postal Code Country Lender Phone Number (###) ### #### Lender Fax Number (###) ### #### Lender Email Address Title Services Service Resale/Purchase Commitment/Policy Current Owner Search Modification Endorsement Other Need by Date MM DD YYYY Additional Services Closing Protection Letter 24-Month Chain of Title 12-Month Chain of Title Endorsements Chain of Title Endorsement ALTA 4 (Condominium) ALTA 5 (PUD) ALTA 6 (Variable Rate) ALTA 6.2 (Variable Rate - Neg Am) ALTA 7 (Manufactured Housing) ALTA 8.1 (EPA) ALTA 9 (Comprehensive) Additional Instructions or Information Contact Information Contact Company Contact Name * First Name Last Name Contact Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Contact Phone Number * (###) ### #### Contact Email Address * Customer Reference Number Additional Comments or Instructions Thank you for submitting your form. Please send any additional documentation to customerservice@serviceonetitle.com with the subjest “Additional Documentation for Online Order”.
