2. Condition of Property: Unimproved Improved New Construction

3.Title was Examined from January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 to January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 .

4. Describe previous insurance and any starter relied upon
.

5. Does the property abut or contain any tidelands, wetlands or water? Yes No

6. Has there been any construction within the past 4 months? Yes No
6-a. Has Mechanic's or materialmen's lien coverage been requested? Yes No
(If Indemnity Agreement is to be relied on, please include financial statements from all Indemnitors.)

7. ACCESS: Does the property abut an open and dedicated public way? Yes No
7-a. (Please indicate if public way is of "limited access.") Yes No
7-b. If no, is there an easement for access and was title to the easement that affords access examined? Yes No

8. Describe all special or unusual title risks or problems:
.

9. Describe any special coverage requested:
.

10. Describe method of closing and by whom:
.

I recommend issuance of the policies indicated above.
Agent:
Agent Contact Name:
Address:
Address 2:
Address 3:
Phone: - - Extension:
Fax: - -

Additional Comments: