Summit Title Company Fax Order Form   Print this page, fill in the requested info. and fax it to: 410-583-5375 Date:____________   Your Name:___________________________________ Your Company:__________________________________________________ Your Phone #:____________________Your Fax #:______________________ Email:___________________________________ Check One:   This is a  Refinance____ Purchase____ (If this is a purchase, please fax the signed contract of sale with this order form) Subject Property Address:__________________________________________ County:_____________________ State_____ Zip Code__________________ Is it the Owner's Primary Residence? Yes/No Buyer/Borrower's Name(s):_________________________________________ Second Buyer/Borrower:___________________________________________ Primary Social Security #:__________________________________________ Second Social Security #:__________________________________________ Buyer/Borrower's Daytime Tel. #:____________________________________   Evening Telephone #:_____________________________________________ Mobile Telephone #:______________________________________________ Name of Seller(s) (If Applicable):_____________________________________ ______________________________________________________________ Seller Daytime #:____________________Mobile #:______________________ Lender To be Insured:__________________________________________ Loan Amount: $________________Purchase Price:$____________________ Type of Loan? FHA/ VA/ Conventional (Circle one, if known) Title Binder to be Faxed/Emailed to:__________________________________ At Fax #:_____________________Email:_____________________________ How many mtg. payoffs?(___): Do you want Summit to Order Payoffs?______ If Yes, Please give us the Lender Payoff Info. below: ______________________________________________________________ ______________________________________________________________ Special Instructions:_______________________________________________ ______________________________________________________________ ______________________________________________________________ Need title commitment by?:______________________                                                                        Return to Summit Title Company