Closing-Title Request Form

LEARNED, PRICHARD & ASSOCIATES P.C.

4150 WESTOWN PARKWAY SUITE 302
WEST DES MOINES, IA 50266
PHONE #: (515) 225-8488 FAX #: (515) 225-8495
TITLE@LEARNEDLAW.COM


***PLEASE INCLUDE VERBIAGE OF 24 MONTH CHAIN OF TITLE ON COMMITMENT***

Closing-Title Request Form
* indicates a required field.
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  (mm/dd/yyyy)
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  (mm/dd/yyyy)
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  (xxx-xxx-xxxx)
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  (email@domain.com)
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PURCHASE
REFINANCE
CONV
FHA
VA
1ST MORTGAGE
2nd MORTGAGE
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BORROWER(S) FULL LEGAL NAME(S)
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  (City, State, Zip
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  (City, State, Zip)
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SELLER(S) FULL LEGAL NAME(S)
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  (xxx-xxx-xxxx)
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NEW LOAN COMPANY
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  (xxx-xxx-xxxx)
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EXISTING PAYOFF INFORMATION
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  (xxx-xxx-xxxx)
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  (xxx-xxx-xxxx)
Other
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Learned, Prichard & Associates, PC - 812 Ashworth Road, West Des Moines, IA 50265 - (515) 225-8488