Abstractor Registration
Company Name:
*
(Same as it reflects on your W-9)
Do you have Form W-9?
*
*If yes, please attach a copy of your current Form W-9.
Yes
No
Please select
How many years of experience do you have performing abstracts for the purpose of real estate transfer, or conveyance of title, for attorneys, abstract companies and/or title insurance companies?
*
Primary Contact:
*
Additional Contact:
Street Address:
*
Select State
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Mailing Address:
Mailing address same as street address
Select State
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Office Phone:
*
Mobile Phone:
Fax:
Email:
*
Website:
Can you be reached at all times during the work day?
*
Yes
No
Please select
If not, at what time(s) may we contact you?
Do you have computer access to county records, in office?
*
Yes
No
Please select
What is your source of title information?
Plant
Court/Recorder's office
Please select
If you use a plant
Plant Name:
Plant Owner:
Type of Plant:
How current is plant?
Does plant have E&O coverage?
Yes
No
Please select
Questionnaire
Do you have E&O insurance?
*
*If yes, please attach a copy of your current E&O insurance certificate.
Yes
No
Please select
Are you or the company licensed?
*
*If yes, please attach a copy of current license.
Yes
No
Please select
Are you an agent for any title insurance underwriters?
*
If so, for whom?
Yes
No
Please select
Do you have any claims/judgements pending or have you had any filed against you in the past related to any real estate transaction(s)?
*
Yes
No
Please select
Have you been arrested for a felony in the past?
*
Yes
No
Please select
Is the Company/Agency Minority Owned?
Yes
No
Please select
How many orders can you, and/or your staff, handle per day?
Please upload coverage document as per the template
*
Coverage document template.xlsx
Please provide a list of your abstractors that will provide service for Orchestrate Mortgage & Title Solutions, LLC
Abstractors Name
Years of Experience
Do you have a qualification process in place for your network of abstractors?
*
Yes
No
Please select
×
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