FIRST EQUITY TITLE CORPORATION
1005 FREDERICK ROAD
CATONSVILLE, MD  21228
(410) 788-7823
(410) 788-7844 (FAX)



TITLE REQUEST FORM

Please print out and complete the form below and fax it to us 
at (410) 788-7844.



Purchase		1st		2nd 



Borrower:__________________________S.S.#___________________

Co-Borrower:_______________________S.S.#___________________

Address:___________________________________________________

        ___________________________________________________

Phone #:    Home__________________________ 

	    Work (Borrower)___________________________

            Work (Co-Borrower) _______________________ 

Property County:______________________________________

Loan Amount:__________________________________________

Purchase Price:_______________________________________ 


PAYOFFS:

Lender______________________________________________ 

Account #___________________________________________ 

Phone #_____________________________________________ 

      Order Payoff:    yes         no


Lender______________________________________________ 

Account #___________________________________________ 

Phone #_____________________________________________ 

     Order Payoff:       yes         no


SURVEY NEEDED:        YES                NO


NEW LENDER__________________________________________ 

Broker _____________________________________________

Loan Officer________________________________________

Phone # ____________________ Fax#___________________


****************************************************


Seller Name__________________________________________ 

Address:_____________________________________________ 

        _____________________________________________ 

Phone #______________________________________________



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Date Title Needed________________________________ 

Est. Settlement Date_____________________________ 


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(End of Form)