Valley Title Guarantee - Place An Order

T I T L E I N S U R A N C E & E S C R O W S E R V I C E

Place An Order

( Form best viewed at 800 x 600 resolution. )

( ** - Denotes required field, must be filled out )

Title Order

Escrow Order

Both

( ** - Denotes required field, must be filled out )

Full Name of Person Placing Order:**
Mortgage Lender Company Name:
Loan Officer's Full Name:
Street Address:
	City
	State Zip
Mailing Address:
	City
	State Zip
Phone Number:**
Fax Number:
E-Mail Address:**

Mortgage Broker Company Name:
Loan Officer's Full Name:
Escrow Closing Company Name:
Propery Address of Land Insuring:
Legal Description of Land Insuring:

Loan Amount: (or) Sales Price:

Type of Transaction: Cash Mortgage Refinance Other?

If "Other" please explain:

Transaction for: (if applicable) Mobile Home Construction Remodeling Commercial

Type of Coverage Requested: Standard Extended Equity

Your Reference Number:

Seller's Full Name (1):
Address
	City
	State Zip

Buyer's/Borrower's Full Name (1):
Address
	City
	State Zip

Buyer's/Borrower's Full Name (2):
Address
	City
	State Zip

Seller's Agent Full Name:
Company Name
Address
	City
	State Zip

Buyer's Agent Full Name:
Company Name
Address
	City
	State Zip

Other: Full Name
Company Name
Address
	City
	State Zip

Number of Copies to:

	Mortgage Lender
	Mortgage Broker
	Closing Agent
	Seller (1)
	Buyer (1)
	Buyer (2)
	Seller's Agent
	Buyer's Agent
	Other

* If Social Security numbers or other information is needed we will contact you for more information

Special Instructions:

Special Requests:

Your title and/or escrow order number(s) will be forwarded to you within 4 working hours.
Please refer to these numbers when contacting us about your title or escrow order.

[ RETURN TO HOMEPAGE ]

Street Address:
502 North Second St
Yakima WA 98901

Mailing Address:
Post Office Box 1625
Yakima WA 98907

Phone: (509) 248-4442
Toll Free: 1-800-752-9553

Title Fax: (509) 575-1179
Escrow Fax: (509) 248-3753