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Serving Western Wisconsin and Southeastern Minnesota(608) 519-4634

Lender Title Order Form

Not Refinancing?

Quick Instructions:

  • Complete the form below to the best of your ability.
  • All fields with the red asterisk (*) are required.
  • Click the submit button at the bottom of the page once you have completed the form.
  • If your order was successfully submitted, you will see this message: “Thank you for your order! We will get in touch with you shortly.”
    If you do not see that message, please complete any areas on the form highlighted with a pink background.
  • Property Information

  • Owner / Borrower Information

  • Financing Information

  • Please enter the amount in dollars.
  • Please enter the amount in dollars.
  • Additional Information

  • Order & Transaction Information

  • Name of person completing this form.
  • Enter your email address here if you want to receive an email notification and copy of this form for your records.
  • Phone number of person completing this form.
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