Fortune Title Agency

Purchase Order Form

Property Information
Street Address
City County
Lot Block Qualifier
Seller(s) Information
Seller 1 Company Name
First Name Middle Initial Last Name
Seller 2 Company Name
First Name Middle Initial Last Name
Seller Attorney
Name
Address
Phone Fax Reference No.
Email
Purchaser(s) Information
Purchaser 1 Company Name
First Name Middle Initial Last Name
Purchaser 2 Company Name
First Name Middle Initial Last Name
Purchaser Attorney
Name
Address
Phone Fax Reference No.
Email
General Information
Fortune Title to act as Settlement Agent? Yes No
Survey
Purchase Price Mortgage Amount
Closing Date
Notice of Settlement
Flood Certificate? Yes No
Mortgage Information
Lender Loan Number
Lender's Name
Lender Contact
Phone Fax Email
Lender's Clause
Lender's Address
Additional Information
Contact Information for Party placing Order
Name*
Phone* Fax Email*
Additional Email
Be advised that on all REO Closings, checks will be disbursed within 24 hours of final HUD approvals by ALL parties. Survey costs will NOT be the responsibility of Fortune Title Agency or its agents, but the sole responsibility of the BUYER. The Title Insurance Premium may be paid by the Seller and other costs will be the responsibility of the buyer. It is the BUYER'S responsibility to clarify what costs will be paid by the Seller. If this file is cancelled, then a cancellation fee may be applied to cover any out-of-pocket costs.
Fields marked with an * are required.