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Refinance Expedited Loan

This application is for placing a title insurance order for a residential refinance Expedited loan policy. Expedited search refinances do not include a search of easements and restrictions and can only be used on residential properties.

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

Title Rate

The title insurance premium is $325.00 up to $500,000.00 worth of coverage. Over $500,000.00 add $1.00 per thousand.


Application for Title Insurance:
Refinance Expedited 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:(*)
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Lending Institution:(*)
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Email:(*)
Please enter a valid email address.
Billing Address:(*)
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Billing Address 2
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Billing City:(*)
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Billing State:(*)
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Billing Zip(*)
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Phone(*)
Please enter a valid phone number (xxx-xxx-xxxx)
Date Needed By:(*)
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Fax:
Please enter a valid fax number (xxx-xxx-xxxx)

Expedited Loan Policy Information

Loan Reference Number:
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Loan Amount:(*)
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Loan Type:(*)
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Property Owner Name(s):(*)
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Property Address:(*)
Please enter a property address.
Proposed Insured:(*)
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Anticipated Closing Date(*)
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How many parcel(s) does the subject property contain?(*)
Please enter only numbers.
Requested Endorsements:
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Special Instructions:
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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:
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We have endorsed and adhere to the "Title Insurance and Settlement Company Best Practices Policies".