Stewart Title Guaranty Company Statement Of Information Template
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1STEWART TITLE GUARANTY COMPANY
STATEMENT OF INFORMATION
CONFIDENTIAL - TO BE USED ONLY IN CONNECTION WITH ORDER NO: _____________________
NOTE: THIS FORM IS NEEDED IN ORDER TO ELIMINATE JUDGMENTS AND LIENS AGAINST PEOPLE WITH SIMILAR NAMES
THE STREET ADDRESS of the property in this transaction is:
(IF NONE LEAVE BLANK)
____________________________________________
__________________________________________________
ADDRESS
CITY
• IMPROVEMENTS:
SINGLE RESIDENCE
MULTIPLE RESIDENCE
COMMERCIAL
• OCCUPIED BY:
OWNER
TENANTS
• ANY CONSTRUCTION OR IMPROVEMENTS WITHIN THE LAST 6 MONTHS?
YES
NO
• IF YES, STATE NATURE WORK DONE: ____________________________________________________________________________________
PARTY 1
PARTY 2
___________________________________________________________________
________________________________________________________________
FIRST
MIDDLE
LAST
FIRST
MIDDLE
LAST
___________________________________________________________________
________________________________________________________________
FORMER LAST NAME(S), IF ANY
FORMER LAST NAME(S), IF ANY
_________________________________
_____________________________
_________________________________
___________________________
BIRTHPLACE
BIRTH DATE
BIRTHPLACE
BIRTH DATE
_________________________________
_____________________________
_________________________________
___________________________
SOCIAL SECURITY NUMBER
DRIVER'S LICENSE NO.
SOCIAL SECURITY NUMBER
DRIVER'S LICENSE NO.
I
I
AM SINGLE
AM MARRIED
HAVE A DOMESTIC PARTNER
AM SINGLE
AM MARRIED
HAVE A DOMESTIC PARTNER
NAME OF CURRENT SPOUSE OR DOM. PARTNER (if other than Party 2):
NAME OF CURRENT SPOUSE OR DOM. PARTNER (if other than Party 1):
___________________________________________________________________
________________________________________________________________
NAME OF FORMER SPOUSE/DOM. PARTNER: (IF NONE, WRITE “NONE”):
NAME OF FORMER SPOUSE/DOM. PARTNER: (IF NONE, WRITE “NONE”):
___________________________________________________________________
________________________________________________________________
MARRIAGE OR DOMESTIC PARTNERSHIP BETWEEN PARTIES 1 AND 2
ARE PARTIES 1 & 2: MARRIED?_______
DOMESTIC PARTNERS?_______ DATE OF MARRIAGE/DOM. PARTNERSHIP: _________________
OCCUPATIONS FOR LAST 10 YEARS
PARTY 1 -
________________________________________________________________________________________________________________________
PRESENT OCCUPATION
FIRM NAME
ADDRESS
NO. OF YEARS
________________________________________________________________________________________________________________________
PRIOR OCCUPATION
FIRM NAME
ADDRESS
NO. OF YEARS
RESIDENCES FOR LAST 10 YEARS
PARTY 1 -
NUMBER AND STREET
CITY and STATE
FROM
TO
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
OCCUPATIONS FOR LAST 10 YEARS
PARTY 2 -
________________________________________________________________________________________________________________________
PRESENT OCCUPATION
FIRM NAME
ADDRESS
NO. OF YEARS
________________________________________________________________________________________________________________________
PRIOR OCCUPATION
FIRM NAME
ADDRESS
NO. OF YEARS
RESIDENCES FOR LAST 10 YEARS
PARTY 2 -
(If same as Party 1, write “same”)
NUMBER AND STREET
CITY and STATE
FROM
TO
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
DATE _________________________
HOME PHONE ____________________________
BUSINESS PHONE ___________________________
SIGNATURES ___________________________________________________
___________________________________________________
REV. 6/1/04
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