All Title Insurance is underwritten by First American Title Insurance Company.
Please fill in all fields marked with a *
	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 One Single Family (Detached or Condo) Multi Family Commercial Vacant Land Mobile or Manufactured Home Other
	Explain Other Type of Property
	*Type of Improvement on Property	Choose One None Construction in Progress Construction to be Commenced Existing Structures with No Improvements within Last 90 Days Existing 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 One New Mortgage Cash Sale with Deed to Insured Sale on Land Contract Other
	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 One Mason Muskegon Newaygo Oceana
	Property Located in	Choose One City Township Village
	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 Email
	*Applicant Address
	*Applicant City
	*Applicant State
	*Applicant Zip Code
	*Applicant Phone Number
	*Applicant Fax Number