Title request page

Please fill out as completely as possible. All items in bold must be completed.

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 Today's Date: Closing Date:

Time:
Lender:
 Loan Officer:
 Officer Telephone:
E-mail:
 Fax Number:
 

Attorney to perform closing:

yes

no

Contract or Deed to be Faxed:
yes
 no
Title Type:
Borrowers:
 Sellers:
Property Address:

Property County:
 Deed Reference:

Subdivision/Lot:

Map/Parcel:
 
Listing Agent:

Realty Company:
 Selling Agent:

Realty Company
 

 
 
 
 
 
 
   
Loan Amount:

Term:

Rate:
Escrow Taxes & Insurance
Yes No
Survey Required:
Yes No
 
  Closing Fees:   POC  
 
 
  Origination Fee:
  Discount Points:
  Appraisal:
  Credit Report:
  Recording Fee:
  Flood Cert.:
  Release Fee:
  Credit Life:

Additional Comments:
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Lee and Lee Law Offices
109 East Gay Street
Lebanon, Tennessee 37087
(615) 444-1312