Title Order Request

If you have any questions while filling out the order form please call (719) 587-2776

Date
Ordered by		Total Commission :
Listing Company :		Listing Commission :
Selling Company :		Selling Commission :
Closing Date on Contract :		Use date on contract I want to close ASAP Need to issue amend extend
Type of Closing:
Not a Mail-out - Mail-out to Seller - Mail-out to buyer
Address of Property:
Legal Discription of Property:

Cash Deal - Loan / Lender - Seller Financing
Sales Amount:
Seller
First Name:		Last Name:
Home Phone:		Work Phone:
Cell Phone :		Fax:
Social Security # :		P.O. Box :
Physical Address :		City:
State:		Zip Code:
Email:

Buyer
First Name:		Last Name:
Home Phone:		Work Phone:
Cell Phone :		Fax:
Social Security # :		P.O. Box :
Physical Address :		City:
State:		Zip Code:
Email:

Water Information
Does this property have any water rights? Yes / if yes please fill out information below No
Does the property have a well:	Yes No	Is the well permited:	Yes No
Do you or the seller have any of the water documents:	Yes No	Well Permit #:
Does the property have any Water Stock Certificates:	Yes No	Who currently has the Water Stock Certificates:

CIC Documents We can provide these documents to buyer for a $50.00 fee.
Yes please provide buyer with CIC Dociments No, I will take care of it.

Additional Information regarding this transaction:

Seller