Lender Name Lender Loan Reference No. Lender Contact Name
Property Address Property City/State/Zip
Liability Amount of Prior Policy Date of Prior Policy (dd/mm/yyyy)
Midvale Office Salt Lake City Office Spanish Fork Office Orem Office None Choose a Title West Location
Purchase Refinance Please select an option... Would you like to Purchase or Refinance?
(Once selected, the relevant form will show below.)
Refinance Loan Amount ALTA Loan Policy Premium
CLTA 100 - Comprehensive $20.00 CLTA 116 - Location ALTA 8.1 -E Environmental Lien ALTA 4 - Condominium ALTA 5 - PUD ALTA 6 - Variable Rate
Number of Deeds Number of Trust Deeds Number of Misc. Documents
Purchase $225.00
Purchase Price ALTA Homeowner's Policy Premium
Enter Purchase Loan Amount Loan policy - Concurrent Issue Rate