FROM:						TO:

_____________________________________________	BRIAN TITLE COMPANY, INC.

_____________________________________________	6401 GOLDEN TRIANGLE DRIVE, 
								SUITE 330
_____________________________________________	GREENBELT, MD 20770

PHONE:_______________________________________	PHONE: 301.220.1700

FAX:_________________________________________	FAX: 301.486.0953



TITLE ORDER FORM

COUNTY:____________________________	CLOSING DATE:_____________________

BORROWER:__________________________________________SS#:___________________

CO-BORROWER:_______________________________________SS#:___________________

PROPERTY ADDRESS:_________________________________________________________

__________________________________________________________________________

(PLEASE INCLUDE COPY OF SALES AGREEMENT IF THIS IS A PURCHASE TRANSACTION)

HOME PHONE:_________________________

B WORK:_____________________________	CB WORK:__________________________



LOAN INFORMATION

LIEN POSITION: _____________________	LOAN AMOUNT:______________________

NEW LENDER WILL BE:_______________________________________________________

__________________________________________________________________________

PHONE:______________________________	FAX:______________________________

1ST MTG.:___________________________	ACCT #:___________________________

PHONE:______________________________

2ND MTG:____________________________	ACCT #:___________________________

PHONE:______________________________



ADDITIONAL SERVICES REQUESTED

SURVEY:	__PLEASE ORDER	__DO NOT ORDER	__WILL CALL

TITLE INSURANCE:	__WILL NEED	__WILL NOT NEED