Preliminary Title Insurance Application

Preliminary Title Insurance Application


* Annotates Required Field

Title Policy Information   Title Policy Information

Please provide as much information about the type of policy required.
Type of Transaction (check all that apply)*:
     

  

Type of Policy Needed (check one)*:
     

  

Owners Policy Amount:
Loan Policy Amount:
Projected Date of Closing*:    
   

Property Information   Property Information

Please provide as much information about the property that title insurance will be applied.
Listing Agent Name:
Listing Realty Name:
Listing Agent Phone Number (xxx-xxx-xxxx):
Listing Agent Email:
Selling Agent Name:
Selling Realty Name:
Selling Agent Phone Number (xxx-xxx-xxxx):
Selling Agent Email:
Property Type*:
Address of Property*:
County of*:
Municipality (check one)*:
   
Property ID Number*:
Brief Description:
Prior Policy (check one)*:
   
Existing Mortgage (check one)*:
 
Seller/Current Owner:
Seller Marital Status (check one):      

Purchaser:
Purchaser Marital Status (check one):      

Additional Comments:
   

Contact Information   Contact Information

Please provide all personal contact information for the person requesting the title insurance application.
First Name (Contact Person or Lender)*:
Last Name (Contact Person or Lender)*:
Address:
Address 1:
City:
State:
Zip Code:
Phone Number (xxx-xxx-xxxx)*:
Fax Number (xxx-xxx-xxxx):
Email Address*:

(Back to Title Services)  

Within one business day please expect to recieve a phone, fax, or email conformation that includes your file number. If you do not recieve this confirmation, please contact us at (989)839-5281.

Submit any supporting documentation such as, purchase agreement, prior policies, tax bills, etc to CFC fax (989)839-6597 or cfctitle.orders@chemicalbankmi.com.