Town N' Country Form

To Electronically Submit an Order, fill out the information below and click "submit" when completed.

Order Type	Owner's Policy Lender's Policy Letter Report Realtor Fact Sheet Search Packet (30/40/60yr)
Sale Amount
Loan Amount
Property Address
Legal Description (if available)
Tax Parcel Number
County	La Crosse Trempealeau Monroe Vernon Other
Seller/s Name
Mailing Address (Forwarding Address)
Phone Number
Social Security Number	*only required for deed and transfer preparation
Buyers/Borrower's Name
Mailing Address
Phone Number
Social Security Number	*only required for deed and transfer preparation
Listing Agent
Email Address
Phone Number
Fax Number
Selling Agent
Email Address
Phone Number
Fax Number
Lender
Email
Phone Number
Fax Number
Ordered By
Closing Date
Closing Location
Deed and Transfer Preparation	Yes	No
Closing Protection Letter	Yes	No
Additional Information