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AFA Online Order Form

Transaction Type: Title Services:

Loan Type:

Property Type:

Loan Number:

Your Sales Representative:

PROPERTY INFORMATION SECTION:

Property Will Be:

Loan Amount for Refinance:
PLEASE DO NOT USE COMMAS

Street Address:
City: State:
Zip Code: County:

BORROWER INFORMATION:

Borrower Name:
Borrower Name:
(Include Jr. or Sr. if applicable)

Borrower Phone:

Is the Address the same Address listed in Property Info section?

If not, please supply address here:
Street Address:
City: State:
Zip Code:

LENDER INFORMATION:

Company:
Contact:
PRIMARY PROCESSING EMAIL IF DIFFERENT THAN CONTACT
Email:

Company Street Address:
City: State:
Zip Code:

Loan Officer/Sales:

PAYOFF SECTION:

Do you need AFA to obtain the payoff(s)?
If you need AFA to retrieve the payoff, please contact our office at 610-640-2040 or email your request to: titledept@afatitle.com. We require a borrowers authorization, the account number(s) and social security number(s) to acquire a payoff.

If this transaction is a PURCHASE, please supply
SELLER INFORMATION:

Seller Name:
Seller Name:
(Include Jr. or Sr. if applicable)

Seller Phone:

Street Address:
City: State:
Zip Code:

COMMENTS: