Place An Order - ATA National Title Group

Customer Information

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Brand

Your Name*

Your Company Name

Address

City

State*

Zip

Daytime Phone*

Fax

Email*

Branch*

Branch (Michigan Greco)*

Branch (Michigan Midstate)*

Branch (Michigan Seaver)*

Branch (Indianapolis)*

Branch (Illinois)*

Branch (GMT)*

Branch (Ohio)*

Sales Rep*

Sales Rep (Michigan Greco)*

Sales Rep (Michigan Midstate)*

Sales Rep (Michigan Seaver)*

Sales Rep (Indiana)*

Sales Rep (Illinois)*

Sales Rep (Ohio)*

Property

Please provide as much information as possible so we may process your order promptly.

Property Type

Property Address

City

State*

Zip

County*

Parcel #

Sale Price

Transaction Amount

Transaction Type

Prior Owner's Policy Number

Underwriter

Sellers

Name 1

Marital Status

Name 2

Marital Status

Work Phone

Home Phone

Seller's Attorney Name

Seller's Attorney Phone Number

Payoff Information

First Mortgage Lender

First Mortgage Amount

(Actual payoff amount will be verified)

Phone

Loan Number

Second Mortgage Lender

Second Mortgage Amount

(Actual payoff amount will be verified)

Phone

Loan Number

Homeowners/Condo Association

Phone

Listing Broker/Agent Information

Agent Name

Broker Name

Office Number

Cell Number

Email

Commission %

Buyers/Borrowers

Name 1

Marital Status

Name 2

Marital Status

Address 1

Address 2

Work Phone

Home Phone

Lender

Loan Officer

Loan Officer Phone

Loan Amount

Loan Type

Buyer Attorney Name

Buyer Attorney Phone

Selling Broker/Agent Information

Agent Name

Broker Name

Office Number

Cell Number

Email

Commission %

Notes

Additional Information

Files

Please attach any word or PDF documents that pertain to this order here. Max combined size 8MB.

File

Drop files here or

Accepted file types: doc, docx, pdf, Max. file size: 20 MB, Max. files: 3.

DOC, DOCX or PDF

Name

This field is for validation purposes and should be left unchanged.