Title Services Request Form for Lenders - ACS Title & Closing Services

The fields with a red asterisk ( * ) are required, however, we ask that you please take the time to fill out the entire form as the speed and quality of our service depends on it. Thank you!

Date

Your Email Address *

From *

Phone

Fax

Contact Person *

First

Last

Property Address

Address Line 1

Address Line 2

City

State

Zip Code

Borrower's Name

Borrower's Address (if different than above)

Marital Status

Borrower's Phone #

Borrower's SS#

Spouse's SS#

Sale Involved?

Seller's Name

First

Last

Seller's Phone

Seller's Address

Address Line 1

Address Line 2

City

State

Zip Code

Legal Attached?

Proposed Closing Date

Borrower's Insurance Company

Payoffs To:

(1st)

Account # (1)

Phone (1)

Payoffs To:

(2nd)

Account # (2)

Phone (2)

Special Instructions