Please fill in all fields marked with a *
	Choose an Underwriter	Choose OneSecurity Title Insurance CompanyFirst American Title Insurance CompanyNo Preference
	Amount of Insurance for Owners Policy
	Amount of Insurance for ALTA Mortgage Insurance Policy without Standard Exceptions
	Amount of Insurance for ALTA Mortgage Insurance Policy with Standard Exceptions
	Type of Property	Choose OneSingle Family (Detached or Condo)Multi FamilyCommercialVacant LandMobile or Manufactured HomeOther*
	Explain Other Type of Property
	Type of Improvement on Property	Choose OneNoneConstruction in Progress Construction to be CommencedExisting Structures with No Improvements within Last 90 DaysExisting Structures with Construction Completed within 90 Days*
	Buyer Name as it should appear on Deed for Owners Policy
	Name of Proposed Insured as it should appear on Mortgage Policy
	Type of Transaction	Choose OneNew MortgageCash Sale with Deed to InsuredSale on Land ContractOther
	Borrowers Name for New Mortgage
	Buyers Name for Sale on Land Contract
	Explain Other
	Name of Present Owner or Seller
	Social Security Number of Present Owner or Seller
	Other Outstanding Interests on Property
	Property Located in the County of	Choose OneMasonMuskegonNewaygoOceana
	Property Located in	Choose OneCityTownshipVillage
	City Township or Village of
	Description of Property
	Property Identification as it Appears on Tax Bill
	Seller Address
	Seller City
	Seller State
	Seller Zip Code
	Buyer Address
	Buyer City
	Buyer State
	Buyer Zip Code
	Property Address
	Property City
	Property State
	Property Zip Code
	Upon Completion of Title Commitment please fax to Attention of
	Fax Number
	Or Mail to Attention of
	Street Address
	City
	State
	Zip Code
	Additional Instructions
	Applicant Name	*
	Applicant Address	*
	Applicant City	*
	Applicant State	*
	Applicant Zip Code	*
	Applicant Phone Number	*
	Applicant Fax Number	*