Title Insurance Form

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Existing Owner Title Insurance Order Form Please return this form by one of the following methods: By Fax to 905-668-9737 By Email to mark@durhamlawyer.ca In Person at 700 Brock Street South, Whitby, Ontario

Email Address:    Property Owners: (Names as they appear on title)

Residence Contact No: Cell Phone Contact No: Business Contact No:

Full Property Address: (Include city and postal code)

Mailing Address (If different from above)

Attached is a copy of the most recent: Select Property Tax Bill Transfer/Deed Presently, the property to be title insured is: Select Residence occupied by current owners Investment residential property that is tenanted Cottage or recreational property Other:

The undersigned acknowledges that The Platinum Title Insurance policy from First Canadian Title Insurance will not be issued until payment has been made in full.

Name: Date:

Type text as it appears: