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ORDER FORM

Please note REQUIRED FIELDS
 Choose Type of Service
* Requested Service:
 (required field)
* Type of Order:
 (required field)
 Choose Delivery Method
E-Mail
Fax
 Contract Information
New Lender/Proposed Insured:
Loan Amt:
Property Information
* Property Address:
 (required field)
* City:
 (required field)
* State:  (required field)
* Zip Code:  (required field)
* County:  (required field)
Parcel Number:
Legal Description:
 Seller's Information
* Seller Name1:
 (required field)
Seller Name 2:
Seller Name 3:
Seller Name 4:
 Buyer's Information
Buyer Name 1:
Buyer Name 2:
Buyer Name 3:
Buyer Name 4:
 Seller's Agent
Agent:
Company:
Phone:
Fax:
E-Mail:
 Buyer's Agent
Agent:
Company:
Phone:
Fax:
E-Mail:
 Broker Information
Company Requesting:
Address:
City:
   
State:
Zip:
    
Phone:
    
Fax:
Loan Officer:
Processor:
E-Mail:
Notes:
Form Submitter's Information  
* Your Name:  (required field)
* E-Mail:  (required field)

Required Fields Denoted by an *

If you would like LEGENDS TITLE, LLC. to order payoffs,
please fax borrower's authorization and mortgage info to 801-352-1590

Thanks For Using Legends Title!