Order Form

Flagle~5.1.JPG (43521 bytes)

Established 1917

On- Line Order Form

Date Ordered:
Ordered By:
Company Name:
Phone Number:
Fax Number:
Purchase Price:
Loan Amount:
Closing Date:

Mail or Fax Binder/Letter Search to:

Attn:

Street:

City:

State:

Zip Code

Seller:

Address:

Street:

City:

State:

Zip Code:

Buyer/Borrower:

Address:

Street:

City:

State:

Zip Code:

Legal Description::

Lot:

Block:

Section:

Extended Legal

Description

(if necessary):

Property Address and County:

Title Binder:

Owner's Policy

Mortgagee's Policy

Contract for Sale**

Refinance

Construction

O & E Search:

Dates:

From
To

Endorsements Required:

Revolving Credit

ALTA 4 (Condo)

ALTA 5 (PUD)

ALTA 6 (APR)

ALTA 6.2 (APR w/Negative Amortization)

ALTA 7 (Manufactured Housing)

ALTA 8.1 (Enviromental Protection)

Florida Form 9

Navagational Servitude

Additional Information:

**	If the Transaction is a sale please fax the Signed Contract or Agreement to (386) 437-1913 or e-mail a scanned copy to FCAC@flaglercountyabstract.com

On- Line Order Form