Mailing:
P.O. Box 251
Oshkosh, WI 54903-0251
Physical:
901 Witzel Avenue
Oshkosh, WI 54902
Phone: (920) 235-0017
Fax: (920) 235-2122

Application for Title Insurance: Refinance Loan

This application is for lending institutions to complete and should be used in conjunction with first mortgage situations. To ensure a prompt response, please make sure you fill out as many of the listed fields as possible. Your information will be kept confidential. We won’t sell, trade, or lease your information to anyone. May we suggest that an “Authorization to Release Confidential Information” be submitted via fax or mail with this application. This form enables us to order payoffs and retrieve information for the closing.

Name

Property Owner

Property Address

Tax Key Number

Legal Description

Lender

Loan Officer

Proposed Insured

Same
To read as follows

Loan Amount

Loan Type

Requested Endorsements

Anticipated Closing Date

Property Type

1 - 4 Family Residential
Condo
Land
Commercial Property
Other

Prior Title Evidence

I'll fax a copy of the old title insurance
Pickup Abstract at

Conditions of Title Known

Special Instructions

Order City Letter
Provide Current Tax Print-out

Ordered By/Name & Co

Lender's Address

Phone

Fax

Thank you for choosing Assurance Title, where our pledge to you is safety, certainty and confidence.

Place an Order

Title Insurance

New Construction

Place an Order

For Sale By Owner

Application for Title Insurance: Refinance Loan