Fidelity Land Title, LTD.

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*Sale Price:
*Property Address:

City:
State:
Zip:

*SELLER:
Seller's Address (if different from above):

City:
State:
Zip:

BUYER:
Buyer's Address:

City:
State:
Zip:

LENDER:
Address:

City:
State:
Zip:
Tax ID Number (if available):
Click on any additional endorsements/services needed:	Check Special Assessments Copy of Tax Bill GAP Coverage Order Deed Section 1031 Tax Deferred Starker Exchange Prepare Closing Statement Fidelity Land Title, Ltd. Closing Services Other
Need by:
How would you like to receive this title order:	Fax Mail E-mail
This title order should be billed to:
*Name:
*Address:

*City:
*State:
*Zip:
Attn:
*Phone Number:
Fax Number:
*E-mail:

Additional copies should be sent to: Additional Comments: Back