Long & Foster Settlement Services, LLC

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AMERICAN PATRIOT SETTLEMENT SERVICES
Refinance Title Application

Phone 610-225-6059 ~ Fax 610-225-2418

Please provide AS MUCH information as possible to expedite order.
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Contact Information

Your Name:

Phone:

Fax:

E-mail

Premises to be Insured:

Street Address:

City:

State:

Zip Code:

Twp/Borough:

County:

Property/Parcel Tax ID:

Refinance Amount:

Projected
Settlement Date:

Owner:

Mortgage Company:

Loan Officer:

Phone:

Fax:

Email:

Processor:

Phone:

Fax:

Email:

Pay Off Information

1st Mortgage Lender:

Account #:

2nd Mortgage Lender:

Account #:

Thank you for your business. Please call 610-225-6050
if you have any questions.

DO NOT PRESS SUBMIT UNTIL YOU HAVE CHECKED YOUR ORDER FOR ACCURACY! Thank you.

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