Colonial Title, LLC

First Name:

Last Name:

Property Address:

(no spaces)

Please answer the questions below about your new property.

1. This title insurance quote is for: Sale / Purchase      Refinance

2. If Sale or Purchase, what is the purchase price? $

3. What is the amount of the new mortgage? $

4. What date do you anticipate closing? (mmddyyyy)

5. What is your role in the transaction? Buyer      Seller      Mortgage Originator      Realtor      Borrower

6. Is the Buyer or Seller paying for the title policy? Buyer      Seller

7. Comments or Questions:

Please fill in the following information and one of our team members will get back to you within 30 minutes if request was submited during
business hours (8:30 A.M. - 5:00 P.M.). If the request is submitted outside of business hours, one of our team members will get back to you
by 9:00 A.M. the following working morning. Thank you!