Order Application

Welcome to the H. B. Wilkinson Title Company - Title Insurance Order Form. Please fill in as much of the following information as possible. Required information is in red.

CUSTOMER INFORMATION

State:
Zip:
E-mail:
Phone:
Fax:

PROPERTY INFORMATION

Street Address:
City:
State:
Zip:
County:
Tax Parcel ID:
Property Type:
Residential Commercial Other Legal
Description: (If available)

TITLE WORK INFORMATION

Date Ordered:
Order Product(s):
Loan Policy Owner's Policy Ownership and Lien Search
Order Type:
New Construction Resale Refinance
Owner(s)/Seller(s):
Buyer(s):
Lender:
Address:
City:
State:
Zip:
Phone:
Fax:
Contact Person:
Closing Date:
   
Payoff Lender:
Payoff Amount: $
Phone:
Loan Number:
   
Selling Agent:
Phone Number:
   
Insurance Agent:
Phone Number:
   
For Title Insurance:
Lender's Policy Coverage $ (Loan Amount)
Owners' Policy Coverage $  (Sales Price)
Endorsements:
Comprehensive Location Environmental Other
Will a closing be conducted by HBW Title Co.? Yes No
Will flood certification be provided by HBW Title Co.? Yes No
Comments or additional information
Please verify that all information entered is correct. Once you hit "Send Order" changes cannot be made without contacting your local H.B. Wilkinson Title Office. Thanks!