Ticor Title Indiana
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Order for Title Insurance

* fields are mandatory.
Date Order Needed by(mm/dd/yyyy):  
Sales Rep:
*Charge to Company:  
*Attn:  
*Address:  
*City:  
*State:  *Zip:  
*Phone(###-###-####):   
Fax(###-###-####):   
Loan/Customer No.:
Listing Agent (full name):
Listing Office:
Address:
City:
State: Zip:  
E-Mail:  
Phone(###-###-####):  
Fax(###-###-####):  
Selling Agent (full name):
Selling Office:
Address:
City:
State: Zip:  
E-Mail:  
Phone(###-###-####):  
Fax(###-###-####):  
Special Information Report(Title/Lien Report)
Owner's Policy Amount (Purchase Price): $  
(Cash Sale) (Contract Sale) (Assumption) (Foreclosure Purposes)
Lenders's Policy Amount (Mortgage Amt): $ 
(first mortgage) (second mortgage) (first & second mortgage) (refinance)
Copies To:
Will order close at Ticor: Yes No
Closing Office Location:
Prior Title Evidence:
Verify Legal Required? Yes No
Flood Certification:
(Life of Loan Certification) (Standard Certification)
Endorsements Required: EPA (8.1) Comprehensive (300) Adjustable Rate Revolving Loan Location Condo Other
Proposed Insured(s)
Owner's Policy:
Proposed Buyer(s): Husband & Wife Tenants in common Joint tenant Corporation Partnership Other
Current Address(Buyer):
Street: City: State: Zip: 
Lender's Policy(Proposed Lender):
Name: Street: City: State:Zip:  
Present Owner(s):
*Present Owner(s):  
Street: City: State: Zip:  
Property To Be Searched (Property Address and Legal Description)
*Property Street:  
*Property City:  *Property State:  *Property Zip:   
Key No./Tax ID No./Dup No.: Residential Commercial New Construction Vacant Other:
Subdivision Information Lot: Block: Plat File: Book: Page:
Subdivision:
Acreage Information Section: Township: Range:
Additional Description:
Special Instructions: Estimate: Yes No
Amount:$  
per
Instruments to Record County of Property:
Person Placing Order:
Phone(###-###-####):  		Enter your email for confirmation of order:  
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Disclaimer: The information contained in this website is intended for general informational purposes only, and should not be construed as legal advice or legal opinion by the author or TICOR Title Insurance Company on any specific facts or circumstances. The information and law set forth herein is subject to change and the information provided should serve as a guide only for use in specific situations. The author hereby disclaims any and all responsibility or liability which may be asserted or claimed arising out of any reliance upon information set forth in these materials.