Order Information
Order Date:
       
Closing Date:
       
Due Date:
       
Order By:
Company:
Phone:
Fax:
E-Mail:
Property
Address:
Address:
County:
City:
State:
Zip Code:
Tax ID:
Legal Description:
Transaction Information
Type of Transaction:
If "Other" specify
Sales Price:
$
Loan Amount:
$
AllianceTitle to Process:
Alliance Title to Close:
Seller Information
Seller 1 Name:
SSN:
XXX-XX-
Seller 2 Name:
SSN:
XXX-XX-
Address 1:
Address 2:
City:
State:
Zip Code:
Phone:
Cell Phone:
E-Mail:
Buyer Information
Buyer 1 Name:
Buyer 2 Name:
Address 1:
Address 2:
City:
State:
Zip Code:
Phone:
E-mail:
Title to be held:
Listing Agent Information
Company:
Company Phone:
Agent Name:
Phone:
Cell/VM:
Fax:
E-Mail:
Commission:
Listing Agent:
 Selling Agent:
%
%
Total Commission:
Selling  Agent Information
Company:
Company Phone:
Agent Name:
Phone:
Cell/VM:
Fax:
E-mail:
Lender Information
Lender:
Financing Institution:
(Please state proposed insured exactly how  it will
show on title commitment)
Phone:
Fax:
Loan Originator:
Loan Processor:
Financing Type:
Seller Assistance:
Second Mortgage Information:
Existing Lien Information
Payoff 1
  
Mortgage Company:
Account Number:
Phone:
Payoff 2
  
Mortgage Company:
Account Number
Phone:
Inspections Order
Inspections Due:
Contract Signed:
Entry Instructions:
KeyBox
  
Contact Seller
Vacant
  
Contact Listing Agent
Other
Specify
  
Inspection
Type
Company
Who Should
Order
Termite
Heating
Cooling
Plumbing
Electric
Roof
Septic
On-Site
Well
Water Test
Whole House
Radon
Structural
Please be advised that Alliance Title & Settlement Services, Inc. will be ordering ALL inspections on behalf of
the buyer as a third party and accepts no financial obligations.  Should the file "Fall Thru" or for any other
reason the inspections not be used, it will still be the responsibility of the buyer to render the total amount
owed to the inspection company.
Special Instructions
"Our Customer service is... our best salesman"
ALLIANCE TITLE
&
SETTLEMENT SERVICES, INC
513 MCKINLEY
MISHAWAKA IN 46544

PHONE:             1.888.202.0508
FAX:                     1.574.258.0509
E-MAIL                customers@alliancetitle1.com