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					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 #______________________________________________



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


Date Title Needed________________________________

Est. Settlement Date_____________________________


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

(End of Form)

				
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