Platinum Abstract Company, LLC
Meeting

Order Title

To get started on your title insurance through Platinum Abstract Company, LLC., please provide the following information:

Order place by:
Sales Price:$
Property Address:
Block:
Lot:
Township:
County:
Prop Type:
Deposit:$
Settlement Date:

SELLER INFORMATION: INCLUDE DOB AND PHONE AND EMAIL (IF AVAILABLE)
Full Name:
DOB:
Full Name:
DOB:
Phone:
ORDER PAYOFFS: IF YES, PROVIDE MORTGAGE CO. NAME, LOAN AND PHONE NUMBER.
Yes No 
Mortgage Co. Name:
Loan Number:
Phone:
ORDER DEED:Yes No 
ORDER CONDO DUES STATUS LETTER: IF YES, PLEASE PROVIDE CONDOMINIUM ASSOC., NAME AND PHONE NUMBER
Yes No 
Condominium:
Phone:

BUYER INFORMATION: INCLUDE DOB AND PHONE AND EMAIL (IF AVAILABLE)
Full Name:
DOB:
Full Name:
DOB:
Phone:
ORDER SURVEY:Yes  No 
TERMITE:Yes  No 

BUYER'S MORTGAGE CO. INFORMATION:
Company:
Contact:
Address:
Phone:
Email:
Mortgage:$
Seller Concession:$

BROKER/REALTOR INFORMATION:
Listing Agency:
Address:
Agent Name:
Phone:
Email:
Buying Agency:
Address:
Agent Name:
Phone:
Email:

Platinum Abstract Company, LLC. • 16 N. Centre St., • Merchantville, NJ 08109  • 856-797-3535 • admin@platinumtitlenj.com • Licensed NJ & PA