Great Lakes Title of Michigan

Place an Order for Title Insurance

Please enter the following information to order Title Insurance Services
* = Required

*General Information*
* Transaction Type
Sales Price
Loan Amount
Lender Name
Lender Address	(Street, City, State, Zip)

*Property Information*
* Street Number
* Street Name
* City
* State
* Zip
Legal Description

*Party Information*
Seller/Owner
	Check here if Seller/Owner is a Company or Partnership
Company Name
1. Seller(s) Name
2. Seller(s) Name
	Check here if there are additional Sellers/Owners

Buyer/Borrower
	Check here if Buyer/Borrower is a Company or Partnership
Company Name
1. Buyer(s) Name
2. Buyer(s) Name
	Check here if there are additional Buyers/Borrowers


*Title Services*
Need by Date (MM/DD/YYYY)	(if a service is selected)

Special Instructions

*How to Contact Me*
Company Name
First Name
Last Name
Mailing Address

City
State
Zip
* Phone
Fax Number
* Email
Comments

This form may contain confidential material for the sole use by the intended recipient(s). Any review, use, distribution or disclosure by others is strictly prohibited. The information contained herein is intended to be used solely for the ordering of real estate information. Any other use of the information is also prohibited.