Land Title Inc

Step 1 of 5

20%

What would you like to do?*
- Submit a Title order
- Please contact me to discuss
Your Email (So we can get back to you)*
Office Locations
Which Land Title office would you prefer to work with? (check one)*
- East Location (240 N Rock Road Suite 355 Wichita, Kansas 67212)
- West Location (10100 W Maple St Wichita, KS 67209)
Anticipated Settlement Date:
Document Upload (PDF ONLY)
Accepted file types: pdf.
Which Closer Do You Prefer To Work With?

Property Information
Property Address
Street Address Address Line 2 City State ZIP Code
Purchaser/Borrower Information
Buyer 1 (B1):
Buyer 2 (B2):
Phone 1 (B1):
Phone 2 (B2):
Present Address
Street Address Address Line 2 City State ZIP Code
Email
Enter Email Confirm Email
Married?

Seller Information (Purchase Transactions Only)
Seller 1 (S1):
Seller 2 (S2):
Phone 1 (S1):
Phone 2 (S2):
Present Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Married?

New Loan Information
Lender (1st):
Acct Number:
Phone:
Lender (2nd):
Acct Number:
Phone:

Real Estate Agent Information (Purchase Transactions Only) : Commission
Total Commission Percent:
Selling Agent Percent:
Flat Commission Fee (Admin):
Listing Agent Percent:
Flat Commission Fee (Admin):
Selling Agent
Name
Office
Phone
Special Instructions
Listing Agent
Name
Office
Phone
Special Instructions