Order Form

Atlas Settlement, LLC
332 Fifth Avenue
Warner Center, Suite 550
Pittsburgh, Pennsylvania 15222

(p) 412-232-3870
(f) 412-471-3175

Residential and Commercial Real Estate Title Insurance and Closing Services

Atlas Settlement Services
Order Form

Agent Name

Phone:

Email:

Fax:

Owner 1

Name
Phone

Owner 2

Name
Phone

Property Information

City State

Lot#

Municipality/Township/Boro

Loan Type: Owner-Occupied Refinance
Non Owner-Occupied 2nd Mortgage

Lender

Is this a purchase? Yes No

Is this an investment property? Yes No

Seller 1	Name Phone
Seller 2	Name Phone

:Additional Comments or Special Instructions:

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