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Title Insurance
Closing Services
1031 Exchange
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Commonwealth Land Title Insurance Company
United General Title Insurance Company
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Today's Date:
Due Date: 
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CONTACT DETAILS
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Street Address:
Address (cont.):
City:
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Work Phone:
Home Phone:
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Record Owner:
Marital Status:
Date of Marriage:
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PROPERTY DETAILS
Lot:
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Address (cont.):
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Back Title/Deed Book:

PURCHASER DETAILS
Purchaser:
Marital Status:
Date of Marriage:
Maiden Name:
Purchase Price: $
 Mortgagee Clause
Mortgagee Address:
Address (cont.):
City:
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MORTGAGE DETAILS
Mortgage Amount: $
Construction Martgage: Yes     No
Variable Rate: Yes     No
Closing Service Letter: Yes     No
Attorney:
   
Survey To Be Provided By: Applicant     Cortes & Hay, Inc.
OR... Obtaining Survey Affidavit of No Change
OR... No Survey, Survey Affidavit
   
Tax Assessment & Superior Courts: Yes     No
Flood Hazard Certificate: Yes     No     Life of Loan:
Notice of Settlement: Yes     No
Cortes & Hay To File: Yes     No
   
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Privacy Statement: Cortes and Hay maintains strict consumer privacy standards and guarantees that this information will not be used outside of the purpose of responding to the inquiries presented by the questionnaire. We will NEVER share, sell, or distribute personal information and treat requests received over the internet with the same respect as those we handle in our offices during face-to-face transactions. If you have any questions or concerns please contact us directly. 


80 Main Street, P.O. Box 454 · Flemington, NJ 08822
Tel: (908) 782-8850 · Tel: (800) 239-4952 · Fax: (908) 782-1998
info@corteshay.com