Refinance Form

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Refinance Order Form

Get the Title and Escrow process started by filling out this easy online form. Use the tab
key to move between fields, and click the "Submit" button at the bottom to send.

1. Your Information - enter contact information here:

Ordering Party:
Lender Name:
Address:
City:	State: ZIP:
Phone:	FAX:
Contact Name:
E-mail Address:

2. Please enter the loan (or loans) to be paid off in the transaction.

1st Lender:
Loan Number
Phone:
Email:
2nd Lender:
Loan Number:
Phone:
Email:

Note: If there are more than two loans to be paid off, please include information in the special instructions.

3. Borrower information:

Borrower:
Daytime Phone
Cell Phone
Email:
Last 4 of SS#:

4. Title and Escrow Services Requested - indicate the services you want, the type of Title Policy (if applicable), and any special requests. To specify someone at Empire West, enter their name(s) in the Escrow Officer, Title Officer, and/or Sales Rep fields.

First Mortgage Order Type:
Standard	ALTA Policy

Second Mortgage Order Type:
Standard	Ownership & Encumbrance Report	Limited Loan Policy

Miscellaneous:
Trustee's Sales Report	Litigation Report	Condition of Title Report

Services Requested:
Title & Escrow	Title Only	Other

5. Enter special instructions (if needed).

Special Instructions:

Preferences - please identify your title and escrow officer and sales representative preference (if any):

Escrow Officer:
Sales Rep:

6. Submit Your Request.

If you have questions, please call Customer Service at (602) 749-7069.

Refinance Order Form

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