American Land Title Corp.
16 Willow Ave
Towson, MD 21286
Phone: (410) 825-2582
Fax (410) 825-2583
Land Title Order Form
Your Name
*
Email Address
*
Phone Number
*
(Ex. 800-555-1212)
Proposed Settlement Date
(Ex. xx/xx/05)
Loan Type
Purchase
Refinance
Second Mortgage
Property Address
(As listed on Tax Bill)
Borrower's Information
Borrower's Name
Home Phone
(Ex. 800-555-1212)
Work Phone
(Ex. 800-555-1212)
Seller(s) Information (Purchases Only)
Was a realtor involved?
Yes
No
Seller's Name
Home Phone
(Ex. 800-555-1212)
Work Phone
(Ex. 800-555-1212)
Seller's Agent Name
Seller's Agent Phone
(Ex. 800-555-1212)
Buyer's Agent Name
Buyer's Agent Phone
(Ex. 800-555-1212)
Existing Mortgages
1st Mortgage Holder
Account Number
Phone Number
(Ex. 800-555-1212)
2nd Mortgage Holder
Account Number
Phone Number
(Ex. 800-555-1212)
IMPORTANT: If you do not receive a confirmation email, please contact
us to verify that we have received your request.
* Required
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