Title Insurance Order Form Complete our online order form and click "Submit Order". Ordered By * Company Name Name * First Name Last Name Branch or Office * Loan Reference No. * Phone * (###) ### #### Fax (###) ### #### Email * General Information & Services Requested Service Requested Owner's Policy Loan Policy Loan Refinance Policy Construction Commitment Jr. Loan Policy Amount $ Other Service Requested (if applicable) Owner's Policy Loan Policy Loan Refinance Policy Construction Commitment Jr. Loan Policy Other Amount (if applicable) $ Mortgagee's Name (if different than company name above) Date Needed MM DD YYYY Closing Date MM DD YYYY Closing at Getty? Yes No I accept the following survey request terms: * Due to instances of multiple survey requests, through Getty and directly by outside parties or their agents, Getty no longer orders surveys. Please Note: if you will be requesting Extended Coverage, it is your responsibility to order a survey and provide us with a copy. I understand and accept these terms. Property Information Property Address Address 1 Address 2 City State/Province Zip/Postal Code Country County * Tax Parcel Number Legal Description Name of 1st Buyer Mortgator (Refi.) Name of 2nd Buyer Mortgator (Refi.) Current Address Address 1 Address 2 City State/Province Zip/Postal Code Country Name of 1st Seller Name of 2nd Seller Listing Realtor Selling Realtor Comments Read Before Submitting * In accordance with the Gramm-Leach-Bliley Act, Getty-Midwest recommends that you review the Privacy Policy, prior to submitting any information on the above order form. By submitting this order form, you are indicating that you have read and agree to the terms in the Privacy Policy statement. I agree, and have read the terms in the Privacy Policy statement on this website. Thank you, your order has been submitted. Someone from Getty-Midwest will be in touch with you shortly! View Privacy Policy We’re here to answer your questions about title insurance, abstracts, loan closings, settlement services, and more.View our most frequently asked questions (FAQs). VIEW FAQS