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222 4th Avenue W

Ashland WI 54806

www.usechoicetitle.com

phone:(715)682-3333

fax: (715)682-3568

email: orders@usechoicetitle.com

Order Date

Need by Date

Closing Date

Owners Policy Amount

Loan Policy Amount

Services Requested
Letter Report
Closing Services
Other

Owners Name(s)

Buyer Name(s)

Property Address

City, State

County

Lot Size or Acreage

Tax Parcel #

Legal Description

Prior Policy #

Lender Company Name & Loan Officer

Listing Agent Company & Agent Name

Selling Agent Company & Agent Name

Special Notes or Instructions

Name or Person Submitting Order *

Company *

Address

City, State, ZIP

Phone

Fax

Email *