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Request to Order Title Insurance

Your Name * :

Email Address * :

Company Name * :

Address * :

City * :

State * :

Zip * :

County :*

Phone Number :

Fax :

Reference#/Loan# :

No. of copies requested :

Report needed by (MM/DD/YY) :

Type of Coverage

Owners - Sale Price

$Standard :

$ Homeowner's Expanded (Default 1998) :

$Extended :

$Trustee Sale Guarantee :

$Litigation Guarantee :

Open Pre-Escrow:

(Residential Resale Transactions Only. Save $100 off Escrow and 10% on Title at time of closing if we provide both services)

Lenders - Loan Amount

$Standard :

and/or

$ Extended :

$GEM/Equity :

Comments of Special Instructions :

Order Information

Seller/Owner :

Proposed Insured :

Buyer/Borrower :

Please send copies of commitment to... :

Property Address :

City :

State :

Zip :

County :

Tax Account/Parcel No. :

Legal Description :

Additional instructions and comments:

Type:

Vacant	Residential
Commercial	New Construction

Call back with:

Legal	Lot size
Tax	Year built
Other

County To Service Request :

Snohomish County	King County
Pierce County	Other

Enter Image Code * :

Please be aware that should this transaction cancel, there may a minimum cancellation fee of $50 plus tax.

* When Preliminary title and escrow are ordered prior to the mutual acceptance of a purchase and sale agreement, the total escrow fee is reduced by $100. Both Buyer and Seller are also eligible to receive 10% off their Title Insurance Premium for ordering both services through PNWT.