

“Real Estate Transaction Specialists for over 100 years”

Order Form

To order title work, please complete the order form below. You will receive a copy of the order in your email.

Order Information
Order for:	Title Insurance Search/Certificate
Date:
First Name:
Last Name:
Company:
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
Property Information
Legal Description:
Property Location:
Address:
City:
State:
Zip Code:
County:
Tax Parcel ID:
Prior Title Evidence:	Yes (Will be faxed) None
Property Type:	Residential Commercial
Order Type:	New Construction Resale Refinance Home Equity/Second Other
Sales Information
Sellers/Owner:
Buyers/Borrower:
Lenders:
Selling Price/ Owners Policy Amount:	$
Loan Policy Amount:	$
Copies/Additional Instructions:
Date needed:
Please fax the Purchase Contract:	Yes

143 N. Water St. • Decatur, IL 62523
Ph: 217-428-8080 • Fax: 217-428-3421