Summerland Title
Online Order Form

Summerland Title Order Form
Transaction Type: Purchase Refinance
Home Equity Line of Credit (HELOC)
Contact Name:
Company:
Email:
Phone:
Fax:

Seller/Current Owners (First):
Seller/Current Owners (Second):
Seller/Current Owners (Third):
Home Phone:
Work Phone:

Buyers/Borrowers (First):
Buyers/Borrowers (Second):
Buyers/Borrowers (Third):
Home Phone:
Work Phone:

Property Address:
City:
State: Zip:
County:
Township/Boro:

Lender:
Contact:
Lender Address:
City:
State: Zip:
Phone:
Fax:

First:
Amount of New Loan:
  Second:
Amount of New Loan:
Sale Price (if purchase):

Broker/Other Contact:
Company:
Phone:
Fax:

Closing Protection Letter Required: Yes No

Fax Title Commitment/Binder and Closing Protection Letter to:
Contact Lender Broker/Other Contact


Date Needed By
Date (MM/DD/YY):
Approximate Settlement Date:

Closing Location
Fast Action Office Other
If other, please specify:

Homeowner, Condominium Association
Master Association: Phone: Contact:
Community Association: Phone: Contact:

Comments




Summerland Title
440 North Andrews Avenue • Fort Lauderdale, Florida 33301
Office: (954) 468-5551 • Fax: (954) 524-6910

7211 N. Dale Mabry HWY Unit 205, Tampa, FL 33614
Office: (954) 468-5551 • Fax: (813) 932-1130