CENTRAL ILLINOIS TITLE COMPANY ORDER FORM
145 S. Water Street, Decatur, IL 62523

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217-422-1719 (Phone)
217-422-2919 (Fax)

Originals To:
Copy To:
Copy To:
Ordered By:
Phone:; Fax:
Seller(s):
Indicate if married single divorced widow
Address of seller:
Buyer(s):
Indicate if married single divorced widow
Will property being purchased be Buyer(s) principal residence?
Yes No
How do they want to take title?
Tenants by the Entirety (only if buyers are married and principal residence) Joint Tenants Tenants in common
Purchase Price: $
Mortgage Amount: $
Lender Name:
(If cash sale, indicate None for Mortgage Amount/Lender Name)
Property address

Legal Description (if known):

Permanent Index (Tax ID) Number (if known):
Are we to do Deed and Real Estate Transfer Declaration (P-tax)?Yes No
Do you want Central Illinois Title Company to do closing?Yes No
Indicate when search/commitment is needed:
To place an order, you may call us, fax us or press the submit button below. Order acknowledgement will be sent within one day advising initial search/cancellation fee and when we expect to have search results prepared. Final Invoice for order will be sent with search/commitment/documents (payment due within 30 days). Do not send order as an attachment to e-mail as we will not open e-mail attachments.