This application is for placing a title insurance order for a Commercial refinance loan policy. A sixty year search is required on all commercial loan policies, unless Assurance Title is supplied with a copy of the existing Owner's or Loan policy in effect. (Note: Prior title evidence can be uploaded using the application form below)

The current policy supplied must have been a full search which would show any easements and restrictions, and if supplied to Assurance Title your client will receive the discounted Re-Issue Rate. If a prior copy of the existing policy cannot be supplied, then Original Rate would apply.

If you would prefer to download the PDF verison of this form you can do so here: 

Title Rate

For current Wisconsin filed title rates, please contact our office.

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Application for Title Insurance:
Refinance Commercial Loan Policy

Directions:  To ensure accuracy, please complete all asterisk items below and as many of the non-asterisk items to assist us in completing the title order process.

All supplied information will be kept strictly confidential.
Assurance Title complies with the ALTA Best Practice Policies. View our "Privacy Policy Notice."

	Applicant Information
Name of Person Placing Order:(*)	Invalid Input
Lending Institution:(*)	Invalid Input
Email:(*)	Please enter a valid email address.
Billing Address:(*)	Invalid Input
Billing Address 2	Invalid Input
Billing City:(*)	Invalid Input
Billing State:(*)	Invalid Input
Billing Zip(*)	Invalid Input
Phone(*)	Please enter a valid phone number (xxx-xxx-xxxx)
Date Needed By:(*)	... Invalid Input. Please use MM/DD/YY format for date
Fax:	Please enter a valid fax number (xxx-xxx-xxxx)
Loan Reference Number:	Invalid Input
	Refinance Commercial Loan Policy Information
Loan Amount:(*)	Invalid Input
Property Owner Name(s):(*)	Invalid Input
Property Address:(*)	Please enter a property address.
Proposed Insured:(*)	Same as above To read as follows: Invalid Input
	Invalid Input
Anticipated Closing Date(*)	... Invalid Input. Please use MM/DD/YY format for date
How many parcel(s) does the subject property contain?(*)	Please enter only numbers.
Legal Description or Parcel ID/Tax Key Number:	Invalid Input
Requested Endorsements:	Invalid Input
Special Instructions:	Invalid Input
	To receive discounted Re-Issue Rate, please upload existing Owner's or Loan policy. If you cannot upload, please email a PDF of the policy to us at This email address is being protected from spambots. You need JavaScript enabled to view it.. If scanned images are not possible, please fax the title policy to (920) 235-2122 or drop it off at our office.
Prior Title Evidence:(*)	I will upload a copy of the existing title insurance now. *Preferred* I cannot upload a copy of the title insurance policy at this time. Invalid Input
	I will fax a copy of the existing title evidence. I will email a copy of the existing title evidence. I will drop a copy of the existing title evidence off at the office. I am not submitting existing title evidence. Invalid Input
	Fax #: 920-235-2122
	Email to: This email address is being protected from spambots. You need JavaScript enabled to view it.
	Located at: 901 Witzel Avenue, Oshkosh
	A sixty year search is required on all commercial loan policies if Assurance Title is not supplied a copy of existing title evidence.
Upload File:	File types accepted: PDF, JGP, or JPEG under 500KB	File types accepted: PDF, JGP, or JPEG under 500KB
	Important: Upon completion of the above order form you will receive an email confirmation that we have received your title order request. If you do not receive the confirmation, please contact us at (920) 235-0017.
Submit this Application:	Submit
(*)	Invalid Input