This application is for placing a title insurance order for a residential refinance Full Search loan policy. Full search refinances include a sixty year search, which will show any easements and/or restrictions and can only be used on residential properties. To speed up the searching process, a current Owner's or Loan Policy can be uploaded using the form below.  By supplying prior title evidence you can expect your "Refinance Full Search" will be expedited.

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.

---

Application for Title Insurance:
Refinance Full Search 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)
	Full Search Loan Policy Information
Loan Reference Number:	Invalid Input
Loan Amount:(*)	Invalid Input
Loan Type:(*)	Invalid Input
Current 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
	Expedite Your Application To speed up the searching process, upload a current Owner’s or Loan Policy. By supplying prior title evidence you can expect your “Refinance Full Search” will be expedited. Please upload fully completed, scanned PDF images of this documentation now These forms can be downloaded here. File types accepted: PDF, JPG, JPEG Max file size: 500KB If scanned images are not possible, please fax documents to: (920) 235-2122 or drop them off at our office. If you need assistance, we are just a phone call away, please call our office at (920) 235-0017.
Upload Current Owner's or Loan Policy	File types accepted: PDF, JPG, JPEG Max file size: 500KB
	If you have additional files, please email them to This email address is being protected from spambots. You need JavaScript enabled to view it..
	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