Order Request JF


	Online Request Form For Jefferson Co.


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	You only need to include information that applies to your order type. *Required Field

Name:

Company:

*E-mail:

Phone Number:

Fax Number:

Seller # 1:

Seller # 2:

Purchaser # 1:

Purchaser # 2:

Lender:

Property Address:

City:

County:

Legal Description:
Optional !


	Type of Order>>


	If this is a sale; please fax a sales contract to us at 785-856-9229.

Owners policy amount $

Lenders policy amount $

Know Existing Liens:

Previous Title Evidence:

Closing Date:

Selling Agent:

Company:

Listing Agent:

Company:

Additional Instructions:


	Do you need an Insured Closing Letter?

YES


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	Capital Title Insurance Company, L.C.


	Topeka main office: 2641 SW Wanamaker Rd.Topeka, KS 66614 Phone: 785-272-2900 Fax: 785-272-8101


	Lawrence branch office: 4821 W. 6th St, Suite O. Lawrence, KS 66049 Phone:785-856-2900 Fax: 785-856-9229


	Manhattan branch office: 312 Poyntz Ave, Manhattan, KS 66502 Phone: 785-537-9199 Fax: 785-537-9877