Request For Approval To Issue Policy Form Page 2
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2.
If creditors’ rights coverage is requested, attach Creditors’ Rights Checklist and Creditors’ Rights Questionnaire or
similar explanation.
8.
Does this file involve the following? (If applicable, check (√) or write YES; if no, leave blank):
_____
A construction loan
_____
Access based solely upon an easement (i.e., is there no direct access to a dedicated public street?)
If so, was title to the access easement examined? _________
_____
Recent construction performed or completed within the lien period
If so, please describe underwriting: _________________________________________________________.
_____
Lien priority based upon subordination of a lien or mortgage
_____
Tidelands, filled land, submerged land, navigable waters or riparian issues
_____
Title based upon judicial proceedings (e.g., tax foreclosure, condemnation, bankruptcy)
_____
Title based upon foreclosure or deed in lieu of foreclosure
_____
Easement independent of real property (i.e., an easement in gross)
_____
Insured option
_____
Co-insurance with other underwriter(s)
If so, please state co-insurers and amounts _______________________________________________.
_____
Native American (Indian) lands
_____
Water rights
_____
Sheriff’s Sale in last 10 years (other than mortgage foreclosure)
If yes to any of the above, please describe in the next section or by supplement.
9.
Other unusual risks, issues and/or affirmative coverages, if any:
____________________________________________________________________________________
____________________________________________________________________________________
10.
Please verify that you have checked for judgments, state and federal tax liens, statewide child support liens, and
statewide wage claim liens against all SELLERS and BUYERS:
____ YES
____
NO
If no, please explain: __________________________________________________________________
11.
Premium to be charged:
From our examination of the Title and the foregoing, we are of the opinion that the Policy requested can be safely issued.
A copy of the Commitment or Title Report is attached.
Signature: __________________________________________ (Title Examiner/Chief Title Officer/Closer)
Printed Name: ______________________________
Title: _________________________________
PLEASE CONTACT US IF ADDITIONAL COVERAGES OR RISKS ARISE LATER.
This approval is NOT an approval for Reinsurance. If the Policy amount is $150,000,000.00 or larger contact our
Reinsurance Department at 1-800-729-190 even if Reinsurance is not required, so that the transaction may be properly
reported to management.
This approval form must be signed by your State, District or Division Counsel, or other Underwriter before forwarding to a
Senior Underwriter.
APPROVAL
Re:
Title/File/Order No. ____________________________
Based upon the information above given, approval is hereby granted to issue the Policy as requested, subject to the
following: ________________________________________________________________
Local/Regional/Assoc. Senior Underwriter
Senior Underwriter
Senior Underwriter
Senior Underwriter
Rev 02/08
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