Date Ordered:		Lender:
Contact:		Ordered Date:

Phone:
E-mail:
Fax:

1st

2nd

Refinance:

Loan Amount:

Endorsements?

8.1

Form 9

6.1

Other:

Buyer / Borrower:

Social Security #'s:
His:		Her:

Property Address:
City:
State:
Zip:

1st Mortgage Held By:

Loan #:

Payoff Subordinate

2nd Mortgage Held By:

Loan #:

Payoff Subordinate

South Coast Title To Order The Following:

Survey Termite Payoff(s)

Note: Faster service on receipt of payoff statements, you may include the customers signed authorization to release information. Any prepaid costs incurred before closing, such as survey, termite reports and appraisals ordered through our company are liable and are to be paid by the customer, whether or not the loan closes.

Other Closing Notes: