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Request Service
Complete the form below and click submit to send us your request for services.
Also, please fax us a copy of the Purchase Agreement and prior title insurance for reissue credit.
Sellers Name
Sellers Address
Sellers City, State, Zip
Sellers Phone
Sellers Email
Buyers Name
Buyers Address
Buyers City, State, Zip
Buyers Phone
Buyers Email
Property Address or
Brief Legal Description
Tax Number
Owners Policy Amount
Mortgage Policy Amount
without exceptions
with exceptions
Lender
Lender Address
Lender Phone
Lender Email
Lender Fax
Selling Price
Earnest Money Deposit
Commissions
to
Listing Co.
to
Selling Co.
Listing Company
Listing Agent
Listing Agent
Address
Listing Agent Phone
Listing Email
Listing Fax
Selling Company
Selling Agent
Selling Agent Address
Selling Agent Phone
Selling Agent Email
Selling Agent Fax
Existing Mortgage or
Land Contract Holder
Preferred Closing Date
Additional Information
*
Ordered By
*
Confirmation Email Address
Address
Phone
Fax
*Required
Traverse Area Title Service, Inc.
A Title Insurance Agency
434 East Front Street | Traverse City, MI 49686 | ph: 231.946.8881 fa: 231.946.5050
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