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Please fill out the following form to initiate your order. Required fields are highlighted in yellow, but we recommend you enter as much information as possible.
Any Title Searches you buy in the packages below can be used at any point in time, any unused title searches can be refunded in the future at your discretion.

APPLICATION OF TITLE INSURANCE COMMITMENT


APPLICATION OF: DATE:
(Buyers alltony)
ADDRESS: ZIP:
TELEPHONE: FAX:
Email:
PURCHASE OR REFINANCE(Please circle once)
PURCHASE: $ MORTGAGE AMOUNT: $
MORTGAGE COMPANY: ADDRESS MORTGAGE COMPANY:
EMAIL OF LENDER: SELLER(S)**:
(**Full names and marital status as appears on current Deed)
Note: IF either the Seller or the Mortgagor is a business entity, you MUST inform us of its exact name, type of entity (e.g. corporation, LLC partnership) and the State it was formed in.
PURCHSASER(S) MORTGAGOR(S):
Spouse’s Maiden Name
(if married less then 20 years):
PREMISES TO BE INSURED
STREET ADDRESS: ZIP CODE:
MUNICIPALITY: COUNTY:
TAX LOT: BLOCK:
CONDO NAME
(if applicable):
ADDITIONAL SERVICES WE WILL PROVIDE UPON REQUEST
(Note additional costs and fees apply. Call for amounts):
1.ORDER FOOLY YES NO 4. ORDER ENTITY STATUS REPORT? YES NO
2. ORDER SURVEY? YES NO 5. ORDER FRANCHISE TAX REPORT? YES NO
3. RELYING on
SURVEY AFFIDAVIT? 		YES NO 6. ORDER UCC SEARCH? YES NO
(***If so, you must supply a copy of the survey and
it must be less than 10 yrs of for purchase)

7. DO YOU WANT US TO FILE NOTICE (S) OF SETTLEMENT?   YES NO

8. WOULD YOU LIKE TO RECEIVE A COPY OF THE COMMITMENT VIA EMAIL?   YES NO

9. WOULD YOU LIKEUS TO SEND A COPY TO THE SELLERS ATTORNEY
NAME: FAX:
ADDRESS: PHONE:
EMAIL:

10. WOULD YOU LIKE TO RECEIVE A COPY OF THE COMMITMENT VIA EMAIL?  YES NO
Email Of Lender
ANTICIPATED CLOSING DATE?:
WHEN DO YOU REQUIRE THE REPORT TO BE SENT TO YOU?
WILL FORTIS BE CLOSING? YES NO

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We take the guesswork out of real estate transactions. We provide a comprehensive suite of services, including Title Insurance, Closing and Settlement Services and Land Records Management. Find out more…

Fortis Title Group guarantees peace of mind with your piece of property. We look forward to working with attorneys, realtors, builders, banks and mortgage brokers to achieve faster, better and cheaper mortgage originations.

Our mission--- cut red-tape, cover risk, save time, save cost, simplify processes, and secure land investments.
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One DeWolf Road. Suite 206. Old Tappan, New Jersey 07675   Tel: 201-768-2999   Fax: 201-768-1003  Email: info@fortistitlegroup.com

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