Form Ar-20 - Annual Registration Of Title Insurance Agents (Pursuant To Section 16 Of The Title Insurance Act) Page 2

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Form AR-20 (DFI - 12/14/2012)
STATE OF ILLINOIS
DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
DIVISION OF FINANCIAL INSTITUTIONS
TITLE INSURANCE SECTION
TITLE INSURANCE ACT
ANNUAL REGISTRATION OF TITLE INSURANCE AGENTS
(Pursuant to Section 16 of the Title Insurance Act)
FILING YEAR - 2013
LISTED BELOW ARE THE AGENTS BEING REGISTERED FOR THE ABOVE STATED CALENDAR YEAR AND THE AMOUNT OF BUSINESS WRITTEN IN THE
PRECEDING CALENDAR YEAR (Any agent who did not do any business the preceding calendar year but wishing to be registered this year, must be listed and show a zero for
the number of policies and total direct premiums.):
** # OF
TOTAL DIRECT
DOES THE AGENT
POLICIES
PREMIUMS
PROVIDE SETTLEMENT
NAME OF AGENT
ADDRESS
ISSUED
WRITTEN
SERVICES?
________________________________________________________________________________YES_____NO__________________________________________________
PAGE NO.
(Attach additional sheets as needed for listing all agents)

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