Property Being Purchased:* Street Address 1 Street Address 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific Zip Our File #: (if known)Personal InformationBuyer 1:* First Middle Last Best Phone Number:Marital Status Married Unmarried This field is hidden when viewing the formEmail Buyer 2: First Middle Last Best Phone Number:Marital Status Married Unmarried This field is hidden when viewing the formEmail Current Address:Option1 Same as Property Address Street Address 1 Street Address 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific Zip POST Closing Address:Option2 Same as Property Address Option3 Same as Current Address Street Address 1 Street Address 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific Zip Property InformationType of Unit/Property: Single Family Home Townhome Condominium Unimproved Land Commercial Property Survey Yes, Please order a survey on my behalf No, I do not want a survey Note: We highly recommend that you purchase a house location survey unless you are buying a Condominium Unit. We will NOT order a survey unless we are instructed otherwise. A house location survey will cost between $500 - $1,000 for typical subdivided lots less than 1 acre, and you will be responsible for paying for the survey even if settlement is not completed.This field is hidden when viewing the formHome Warranty Company:This field is hidden when viewing the formHome Warranty Cost of Coverage:Home Warranty Provided By: Buyer Seller Lender/Mortgage InformationName of Lender:Loan Officer:TelephoneEmail Additional InformationNotes/Comments:Please review your submission. If all the information is correct, press the "Complete Submission" button. This information will be transmitted securely to Highland Title.
