Contract Application

Please complete the following order form to be sent to your preferred Office.
You may also call the office for pickup or fax to the office.

Office Locations

Property Address:

Brief Legal Description:

Seller Information

Seller (leave blank if refinancing)

Seller's Name: Seller's SSN:

Co-Seller's Name: Co-Seller's SSN:

Marital Status: Seller's Phone:

Seller's Address: City:

State:

ZIP:

Prior Title Policy? Yes No Is This A Mail Away? Yes No

Payoff Information

Lender:		Loan #:
Phone #:

Buyer Information

Buyer's Name:

Buyer's SSN:

Co-Buyer's Name:

Co-Buyer's SSN:

Marital Status:

Buyer's Phone:

Buyer's Address:

City:

State:

ZIP:

Is This A Mail Away? Yes No

Financing Information

Conventional Assumption FHA VA

Lender Name:		Address #:
Phone #::		Contact Name:

Additional Services

WHICH OFFICE WOULD YOU LIKE TO HANDLE YOUR CLOSING?
SURVEY: (THIS IS ORDERED AT LOAN APPROVAL) WOULD YOU LIKE TO ORDER A SURVEY? Yes No

TERMITE INSPECTION (THIS IS ORDERED AT LOAN APPROVAL) WOULD YOU LIKE US TO REQUEST THE INSPECTION? Yes No

IF YES IS THERE A LOCK BOX? Yes No
IS THE PROPERTY VACANT? Yes No

ESCROW DEPOSIT: Deduct from Commission Provide Check At Closing

HOME WARRANTY PROVIDED? Yes No

PAYEE:


Comments:

Thank You for your Order!

Please print this form and call one of our offices for pickup or fax to us at our fax numbers below.

Alday-Donalson Title Agencies of America, Inc.
CORPORATE * (813) 985-7006 * FAX (813 985-7229

TEMPLE TERRACE * (813) 988-2836 * FAX (813) 989-3647		BAYHILL * (407) 637-2347 * FAX (407) 637-2416
CARROLLWOOD * (813) 968-5170 * FAX (813) 968-7871		BRANDON * (813) 685-4576 * FAX (813) 654-6512
KENNEDY * (813) 876-3771 * FAX (813) 874-2801		NEW TAMPA * (813) 978-0480 * FAX (813) 971-4156
SEMINOLE * (727) 391-5955 * FAX (727) 391-4623		ST. PETERSBURG * (727) 323-2424 * FAX (727) 323-2626
SPRINGHILL * (352) 688-7747 * FAX (352) 688-7757