order, Atlantic Land Services

Order your title online by filling out the form below,
or you can fax it to: (201) 768-7058
* Required Field

INFORMATION:

Transaction:

Purchase

Refinance

Heloc

Approximate Closing Date:

ORDERED BY:
Name:
Firm/Company:
*Address:
*City:
*State:
*Zip:
Phone:
Fax:
E-Mail:

PROPERTY:
Street:
Municipality:
County:
Block:
Lot:
Condo:
Unit Number:
Building:
Purchase Price:
Mortgage Amount:

BUYER AND SELLER INFORMATION:
Buyers/Mortgagors:
Marital Status:
Maiden Name:
Sellers:
Marital Status:
Sellers' Attorney:
Phone:
Fax:
Address:
E-mail:

LENDER INFORMATION:
Lender:
Contact:
Phone:
Address:
City:
State:
Zip:
Fax:
Mortgage Clause:

Would you like us to send the above referenced lender a copy of the Commitment?	Yes No
Would you like us to order a Survey?	Yes No
Would you like us to order a Flood Search?	Yes No
Would you like us to file a Notice of Settlement?	Yes No
Would you like us to send attorney a copy of the commitment?	Yes No

CLOSING:

Atlantic Land Services LLC to Close
Closing Attorney (if different from applicant please enter information below)
Bank Review Attorney (please enter information below)

If the closing attorney address is different than entered above or if you are using a Bank Review Attorney, please enter the information below.

EXISTING MORTGAGES - PAY OFF INFORMATION:

If you require that we request pay off information on existing mortgages, please attach a list of the lenders with their addresses and the account numbers for each loan.

OTHER:

Special Requirements/Comments:

Submit to Atlantic Land Services

ATLANTIC LAND SERVICES, LLC
10 McKinley Street, Suite 11, P.O. Box 341,Closter, New Jersey 07624
Telephone: (201) 768-7008 Fax: (201) 768-7058

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