Limited Title Search
Title Insurance

ALTA Owner's commitment		@  $
ALTA Lender's Commitment (with standard exceptions)		@  $
ALTA Lender's Commitment (without standard exceptions)		@  $

Document Preparation

......

(If applicable check box and complete,
otherwise proceed to owner information)

THE UNDERSIGNED HEREBY REQUESTS DOCUMENT PREPARATION SERVICES OF RICHARD A. RANDALL, P.C., ATTORNEY AT LAW

Warranty Deed
Quit Claim Deed
Land Contract
Terms of Land Contract:
Amount of Contract		$
Amount Down		$
Interest Rate		$
Monthly P/I		$
Balloon		Years

Special Provisions:
(Please explain)

Owner/Purchaser Information

Owner(s):
Names:
Status:
Address:
City:
State:
Zip Code:

Purchaser(s):
Names:
Status:
Address:
City:
State:
Zip Code:

How Title will be held by Purchaser:

	Tenants in Common
	Joint Tenants
	Joint Tenants with Full Rights of Survivorship
	Tenants by the Entireties (Husband / Wife only)
	Special Instructions:

Closing Services Requested?

Yes

No

Property Information

Property Tax ID:
Property Address:
Manufactured Home?	Yes  No
If yes, provide make and serial no. in Comments, below.
Property Description:
County:
City/Twnsp:
Description:

Comments:

This section to be used for any specific requests that are to be placed on the deed or land contract. (i.e.- Reservations, easements, etc.)

Order Placed by:
Company:
Date:
Need by:
Contact me at:

Phone	Fax	E-mail
Your E-Mail Address
Your Name