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WEB ORDER ENTRY - WASHINGTON, DC

To send an order to Premium Title & Escrow, please fill out the form below.
Processing will begin promptly. Thank you.

Condominium/Single Family/Commercial Property:
Current Tenants?
1st Time Homebuyer?
Principal Residence or Investment Property?
Transaction Type:
Paramount Title Contact:

Buyer(s)/Borrower(s):		Social Security#		Phone#
Buyer(s)/Borrower(s):		Social Security#		Phone#

Seller(s):		Social Security#		Phone#
Seller(s):		Social Security#		Phone#

Contract Sales Price:

Earnest Money:

Held/Received By:

Property Address:

City:

State:

Zip:

County/Parish:

Listing Agent/Broker:
Phone:
Fax:
Total Commission Rate:

Selling Agent/Broker:
Phone:
Fax:
Total Commission Rate:

Mortgage Broker Firm Name:
Phone:
Fax:
Address:
City, State, Zip

Lender Name:
Phone:
Fax:
Address:
City, State, Zip

Settlement Status:
Mortgagee Clause?

Payoff Information:
Should We Order Survey?
Should We Order Payoff?

Name Of Mortgage Co:		Phone#		Account#
Name Of Mortgage Co:		Phone#		Account#

Please use the "Order Notes" section below to give us any special and/or specific instructions regarding your order.You may also leave an email address and/or telephone/fax number so that we may send a confirmation to you!
Order Notes:

NOTICE AND DISCLAIMER: The information contained on this page is provided for informational purposes only and should not be relied upon as legal advice or as a substitute for a consultation with a qualified attorney.