Custer Title Company

Closing Order Form

Date Ordered
Contact Information:
Name
Business
Address
Phone
Fax
Email
Purchase	Yes: No:
Refinance	Yes: No:
Construction	Yes: No:
Permanent Loan	Yes: No:
Sales Price
Lender
Property Type	Residence: Bare Land: Commercial:
Property Type	Improved: Unimproved:
Any Improvements within the last year?	Yes: No:
Legal Description (required)
Present Owner/Seller
Address
Phone
SS#	/ SS#:
Buyer
Address
Telephone
Email

Listing Agent
Email Address
Phone Number
Fax Number
Listing Agent Commission Fee

Selling Agent
Email Address
Phone Number
Fax Number
Selling Agent Commission Fee
Anticipated Closing Date
Anticipated Closing Time
Would you like Southern Hills Title to Prepare a Deed?	Yes: No:
How is Title to be held by Buyer(s) - Please check ALL that apply or fill in the blank.
A Single Person: Husband & Wife: Tenants in Common: Joint Tenants with right of survivorship and not as Tenants in Common: Other:
Please provide a copy of the purchase agreement to our closing department Please contact our closing department directly to schedule a closing - 605-673-3331