Title Order Form

To send an order to Premier Title, fill out the form below. Processing will begin promptly. If submitting an order for a purchase, please fax the purchase agreement to 952-842-8492. Thank you.

Transaction Type:
Buyer/Borrower:	Buyer/Borrower Home Phone:
Buyer/Borrower:	Buyer/Borrower Work Phone:
Seller:	Seller Home Phone:
Seller:	Seller Work Phone:
Contract Sales Price:	Earnest Money: Held/Received By:
Loan Amount:
Property Address:
City:	State: Zip Code:
Property Tax I.D. #:
Legal Description:
County/Parish:
Listing Company:
Listing Agent Name:	Phone: Total Commission Rate:
Selling Company:
Selling Agent Name:	Phone:
Lender Name:
Lender Address:
Lender Phone:
Lender Fax:
Mortgage Broker Name:
Mortgage Broker Address:
Mortgage Broker Phone:
Mortgage Broker Fax:
Projected Settlement Date:
Closer's Name:
	All orders will be processed and invoiced as Full ALTA work unless otherwise noted below. Thank you.
Order Notes: