Order Form
                             Please be advised security of this page is in process
                                                      Phone 260-420-9344

Date    Estimated Closing Date    Location    Time 

 Type of Order    Purchase w/Mortgage               Cash Sale                       New Construction     
                        Home Contract Purchase           Land Contract Refinance          Refinance   
                        2nd Mortgage/HELOC             Search only                    Search only w/Title Insurance    

Sales Price $   1st Loan Amount  $   2nd Mortgage Amount  $

Property Address      City     Zip    County   

Owners Name    MI SS#   Phone #

Owners Name    MI SS#   Phone #

Buyers names as to appear on Title    Phone #

Broker   Broker Company   Phone #  Fax #

New Lenders Name   Contact Name   Phone #  Fax #

Buyer's Real Estate Agent     Company Name 

Commission    Additional Fees     Phone # Fax #

 Seller's Real Estate Agent    Company Name   

Commission    Additional Fees     Phone # Fax #

Earnest Money  $  Who's Holding 

Is Lincoln Title Co. ordering the payoffs?  Yes  No

Lender Name    Account #  Contact Phone #

Lender Name    Account #  Contact Phone #

Do you have a purchase agreement?  No Yes   Do you have prior Title Policy  No Yes
     (Please Fax to 260-426-8257)                                      (Please Fax to260-426-8257)

Please check any of the following you would like us to order...

   Survey        Pest Inspection      Deed & Closing Affidavit  

        Please be advised security of this page is in process
                                       Please print &  fax to Lincoln Title at this time 260-426-8257