Application for Title Insurance:
Junior Loan Policy and Activation Endorsement

This application is for placing a title insurance order for a Junior Loan Policy and Activation Endorsement. Junior Loan Policies/Activation Endorsements do not include a search of easements and restrictions and can only be used for home equity lines and second mortgages on residential property. The Junior Loan Policy serves as policy and commitment issued when the order is placed.  The Activation Endorsement, delivered after the Mortgage is recorded, creates the effective coverage.

Title Rate: The title insurance premium is $175.00 up to $100,000.00 worth of coverage. Over $100,000.00 add $1.00 per thousand.

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."

Application for Title Insurance: Junior Loan Policy and Activation Endorsement

Applicant Information

Name of Person Placing Order:(*)
Invalid Input
Lending Institution:(*)
Invalid Input
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
Please enter a valid phone number (xxx-xxx-xxxx)
Date Needed By:(*)
Invalid Input
Please enter a valid fax number (xxx-xxx-xxxx)

Junior Loan Policy Information

Loan Reference Number:
Invalid Input
Invalid Input
Property Owner Name(s):(*)
Invalid Input
Property Address:(*)
Please enter a property address.
Proposed Insured:(*)
Invalid Input
Invalid Input
How many parcel(s) does the subject property contain?(*)
Please enter only numbers.
Special Instructions:
Invalid Input

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:

Member Logo web WLTAlogo hdr 4  WHBA logo NoTags sm 
We have endorsed and adhere to the "Title Insurance and Settlement Company Best Practices Policies".