American Title and Escrow - Silver Spring MD 20903

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We will send you confirmation of your title order. If you do not receive a confirmation from us within 4 hours, please call Rifkey Badurdeen at 301-434-3444

Submitting a title order online entitles you to a discount in the amount of $100!

Transaction Type:

Purchase Refinance

Anticipated Settlement Date:

Are you a:

Purchase Information

Sales Price:

Loan Amount:

Refinance Information

Loan Amount:

Property Information:

Property Address:
City:
State:
Zip:
County:
Subdivision:
Lot/Block/Square:

Settlement Location:

Location of Your Settlement:
If other location, please specify where you would like the closing to occur::

Purchaser/Borrower Information:

1st Purchaser/Borrower:
Cell Phone:
Office Phone:
Home Phone:
Email:
Fax:
Present Address
City, State, Zip:
Is this your principal residence
Married:
1st Time Homebuyer in Maryland?


2nd Purchaser:
Cell Phone:
Office Phone:
Home Phone:
Email:
Fax:
Present Address
City, State, Zip:
Is this your principal residence
Married:
1st Time Homebuyer in Maryland?

Seller Information (Purchase Transactions Only):

1st Seller:

Cell Phone:

Office Phone:

Home Phone:

Fax:

Email:

Present Address:

City, State, Zip:

Married:

Attendance At Closing:

Seller 1:
Seller 2:

2nd Seller:

Cell Phone:

Office Phone:

Home Phone:

Fax:

Email:

Present Address:

City, State, Zip:

Married:

Attendance At Closing:

Seller 1:
Seller 2:

* PLEASE NOTE: If the seller will not be present at closing, please notify us ASAP as we must approve the Power of Attorney PRIOR TO SETTLEMENT.

Seller's Payoff Info (if a PURCHASE) OR Borrower's Payoff Info (if a REFINANCE)

Lender (1st):
Acct Number:
Phone No.:
Lender (2nd):
Acct Number:
Phone No:

New Loan Information:

Lender:
Loan Officer:
Phone No.:
Fax:
Email:

REALTOR Information (Purchase Transactions Only):

Selling Agent
Name:
Office:
Office Phone:
Alt. Phone:
Email:
Fax:
Commission:
Admin Fee:

Listing Agent
Name:
Office:
Office Phone:
Alt. Phone:
Email:
Fax
Commission:
Admin Fee:

Special Instructions: