Valley Title & Escrow Agency, Inc.

Title Request

We have several ways you can supply us your information. You can print this form, fill out the required fields and fax it to: (330) 394-5507. You can fill out this form and submit it, then your information is sent directly to us.

Please provide the following information:

Name

Title

Organization

Work Phone

Home Phone

FAX

E-mail

SECTION I:

Select any of the following options that apply:

Tax and legal
Full title search
Lien search
Closing

SECTION II:

Is this a sale?

Yes No

Is this a refinance?

Yes No

SECTION III:

What is/are the purchaser/borrower's name(s)?

What is/are the seller's name?

What is the seller's marital status?

What is the address of the property being sold/financed?

What county is the property in?

What is the sales price?

Who is the lender?

What is the amount of the new loan?

SECTION IV:

Who holds the existing mortgage?

Special instructions, if any:

Or e-mail the above information to:
grieger@valleytitleandescrow.com

Name
Title
Organization
Work Phone
Home Phone
FAX
E-mail