Smith, Welch & Brittain: Attorneys at Law

Please use the form below to submit a Title Request. Fields marked with * are required.

Location Please select the location where you would like to submit the Title Request:
Select location*

Applicant Information Full Name*
E-mail
Company name*
Address*
Address 2
City*
State*
Zip*
Phone*
Fax*

Product and Order Information Product
Type
Loan amount
Sales price
Mortgage position
Loan number
Property address*
Property address 2
City*
State*
Zip*
County*
Special Request

Buyer/Borrower Information Buyer/Borrower*
SSNumber
E-mail
Co-buyer/Borrower
SSNumber
Street address 1*
Street address 2
City*
State*
Zip*
Phone*
Fax

Seller/Owner Information Seller/Owner*
SSNumber*
E-mail
Co-seller/Owner
SSNumber
Street Address 1
Street Address 2
City
State
Zip
Phone
Fax

Lender Information Company name
E-mail
Street Address 1
Street Address 2
City
State
Zip
Phone
Fax

Additional Interested Persons

If you wish any additional parties to receive a copy of the requested title work please furnish the information below. Please remember both Contact Person & Fax number must be completed.

Buyers Attorney Information Company name
Contact person
Street Address 1
Street Address 2
City
State
Zip
Phone
Fax

Sellers Attorney Information Company name
Contact person
Street address 1
Street address 2
City
State
Zip
Phone
Fax

Real Estate Selling Agent/Broker Information Company name
Contact person
Street address 1
Street address 2
City
State
Zip
Phone
Fax

Real Estate Listing Agent/Broker Information Company name
Contact person
Street address 1
Street address 2
City
State
Zip
Phone
Fax