Title Insurance Application

Online Title Application

Please enter the following information to order Title Insurance from Old Republic Title Company of Utah:

Please fill in as much information as is known to you

Attachments such as Purchase Agreements (if applicable) must be faxed to 801-373-2265. 

Thank you for your order!
Order No.                        
Dates               Previous File No(s).  
  Date Received   By   At          
  Need By                      
  Disclosure                      
  Settlement                      
Ordered By Phone Fax        
    Cell        
Property Address Tax ID        
Sellers (Owners)                          
  Name   SS# DOB        
  Name   SS# DOB        
  Home Phone Fax   Cell        
  E-mail                  
Address if other than property address        
Buyers                          
  Name   SS# DOB        
  Name   SS# DOB        
  Home Phone Fax   Cell-Wk        
  E-mail                  
Address if other than property address        
Lender/Broker                          
  Company Name Contact        
  Address Phone            
  Address 2 Fax        
  E-mail                  
  Do they want original report    faxed report    e-mailed report ? Per Date        
Sales Price $ Owners Policy                      
Loan Amount $ Lenders Policy   Endorsements  Std 3   &Or           
2nd Loan Amount $ Lenders Policy   Special               
Order Type/File Type                        
  Residential Sale Residential Refinance Foreclosure                  
  Commercial Sale Commercial Refinance Special Report                  
  Letter Report Commercial Construction Closing Only                  
  Research Only Residential Construction Residential Sale                  
  Other  Listing PR                  
Listing Agent (Sellers)                        
  Name                  
  Company Name                  
  Phone Fax   Cell        
  E-mail                  
  Title Report  - original report    faxed report    e-mailed report                
Selling Agent (Buyers)                        
  Name                  
  Company Name                  
  Phone Fax   Cell        
  E-mail                  
  Title Report  - original report    faxed report    e-mailed report                
  Commission - Listing    Selling                
Is This a Rental Property?  Yes   No                        
Split Closing?  Yes   No                        
  If yes we have  Buyers   Sellers                  
  Other Title Company                  
  Address                  
  Address2                  
  Contact                  
  Phone Fax              
  E-mail                  

Special Instructions/Pay Off:

            
           

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