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Chicago Title
Ticor Title
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Date:
| 2/7/2012 |
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* Your
E-Mail Address:
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Agent/Your
Information:
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Title:
(Mr. Ms. etc):
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* First
Name:
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* Last
Name:
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From
(Branch Office/Agency):
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Branch
Office Address:
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Phone:
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Attn
(Reader, Councel, etc):
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The above-named
Branch Office/Agent hereby requests the Company's approval
for the issuance of the policy or policies described below:
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Policy 1
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| Title
No: |
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Proposed
Insured:
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Amount
of Insurance $
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Type
of Policy:
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(If other, please explain)
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Policy 2
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Title
No:
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Proposed
Insured:
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Amount
of Insurance $
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Type
of Policy:
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(If other, please explain)
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Policy 3
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Title
No:
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Proposed
Insured:
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Amount
of Insurance $
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Type
of Policy:
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(If other, please explain)
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Construction
Mortgage?
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Pending Disbursement Clause inserted?
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If not, why not?
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Special 3-year construction loan policy end't attached?
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If not, why not?
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Street address of property:
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Current use of property:
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Co-Insurance?
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If
Yes, names of other companies involved and liability to
be assumed by each:
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Name
of Company
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Amount
Percentage |
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Reinsurance?
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Requests
to cede reinsurance to other companies, or customer requirements
which differ from the above, should be noted below:
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Name
of Company
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Amount |
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Title Evidence/Title Examination
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Complete
Search by:
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Continuation
from prior owner's policy issued by:
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on (year):
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Other (Please explain):
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Note: If amount of policy to be issued exceeds $20,000,000.00, copy
of prior policy must be attached to this form.
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Business Entities
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Is the
owner or proposed purchaser a business entity?
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If so, what type?
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If other, please
explain:
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Have the
appropriate exceptions / requirements been inserted?
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If not, please
explain:
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Mortgages and Other Leins
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Appropriate
searches performed for mortgages and other leins?
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Mortgages
disclosed by search?
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If not,
has the searcher re-checked mortgages?
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Mortgage
discharged and not replaced by another?
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If so, please
explain:
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Note: In the event the current owner has held title to the property for less than 10 years,
the searcher must re-check the record to confirm that there are no open mortgages, and the owner must confirm - by specific statement
in the affidavit of title -- that he or she has not made any mortgages encumbering the property. If a mortgage has been discharged
and not replaced by another, an explanation by the current owner is required. See U.M. No. 363 (02/03/06). .
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Access
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| Does land abut public street or road? |
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If not,
is access by easement?
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If so,
has a determination been made as to validity of the easement?
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If so,
how was the detemination made?
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Easments
appurtenant?
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If so,
will same be insured?
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If so, how
was detemination made:
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Easments
burdening land?
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If so,
have same been excepted?
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If not,
please explain:
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Easments
located on survey?
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If so,
encroachments of existing structures onto easement areas?
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Request
for issuance of ALTA End'ts Nos. 9, 9,1, 9,2, 9.3, 9.4 or 9.5?
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If so,
basis for determination that end't could be provided:
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Other requests for affirmative
insurance regarding easements?
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If so,
basis for determination that coverage could be provided:
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Restrictions
burdening the land?
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If so,
have same been excepted?
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If not,
please explain:
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Reverter
wording in restrictions?
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Requests for
affirmative insurance regarding restrictions or reverter?
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Wording
of requested coverage:
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If so,
basis for determination that coverage could be provided:
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Pending
litigation affecting title to the land?
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Notice
of List Pendens filed?
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Explain
nature of litigation:
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Request
to "insure over" pending litigation
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If so,
explain basis for request:
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Conveyance
from municipality or government agency?
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If so,
have appropriate executions / requirements been inserted?
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If not,
please explain:
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"Green Acres"
issue?
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If so,
has exception been inserted?
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If not,
why not?
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Title
derived from judicial proceeding?
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If so,
what sort of proceeding (check one)?
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Please
specify type of proceeding
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Abstract
of proceedings obtained and reviewed?
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If not,
why not?
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"Creditors'
Rights" issues?
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If so or unsure,
please explain:
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Request
for issuance of ALTA 21 Endorsement or to provide "creditors rights"?
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If so,
basis for providing coverage:
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Note: Issuance of the ALTA 21 ("creditors' rights") Endorsement
is subject to approval by the Iselin and Home offices. "Creditors' rights" problems include, but are
not limited to, leveraged buy-outs, upstream financing, etc. For more information, see Handbook of N.J.
Title Practice, Chs. 29 (bankruptcy) and 52 (creditors' rights).
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Pending bankruptcy?
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If so or unsure,
please explain:
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Chapter
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If so,
court order permitting transaction to be insured?:
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Subject
to liens?:
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If no court order,
basis for determination that transaction may be insured
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Prior bankruptcy?
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Liens vs. debtor?
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Liens "scheduled"?
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Liens based on discharable debts?
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After-acquired property?
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Court Order discharging liens?
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Other
Information
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Tidelands
search obtained?
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If not,
why not?
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If so,
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If claimed,
appropriate exception(s) inserted in commitment?
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If not,
why not?
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If grant exists,
does grant cover all of claimed area(s)?
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Was grantee upland
owner when grant was made?
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Other water-related
exceptions applicable?
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If so,
exceptions inserted in commitment>
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If not,
why not?
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Fiduciary
transaction?
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If so,
proof obtained that fiduciary is action within the scope of his or her authority?
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Please
explain
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Self-dealing
transaction?
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If yes, please
explain
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Conveyance, etc., for
valuable consideration?
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If not, please
explain
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Is current owner or proposed purchaser
a person under a disability for whom a fiduciary should be appointed?
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Please
explain
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Marital
Rights?
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If so,
nature of marital right
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Other, please
explain
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Both spouses
to execute instrument(s)?
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If not,
explain how marital rights will disposed of
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Other requests for affirmative insurance,
special coverages or endorsements?
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If so,
set forth specific coverage(s) requested
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If so,
basis for determination that coverage(s) could be provided
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Unusual or extra-hazardous risks
(if any) other that those discussed above?
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If so,
please explain
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Other
relavant information:
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