Document Order Form
Requestor Info:
FileNumber:
Need Document By: *
All information below must be filled in completely. Any pertinent information that is left blank may delay completion of this affidavit. The Title Insurance Company will rely upon this information and its representatives to produce a recordable document that will disclose the heirship of the decedent to complete the chain of title for all future parties interested in the subject property.
Name of decedent: *
Address of the Decedent (including county) at time of death:
Marital status of decedent at time of death: Married, Single or, Other (please explain):
Name of Spouse:
Date of marriage:
(*if applicable)
Date of Death:
Date of Divorce:
Name of Second Spouse:
Name of Thrid Spouse:
Name of Affiant :*
Address of the Affiant:
Number of years Affiant knew Decedent: *
Date of Decedent’s Death: *
(***Please attach a copy of death certificate to this questionnaire***)
Decedent’s Place of Death: (Please include City and County)
Did decedent have any children:
*****The term children above refers to all children born to the decedent (even if child was given up for adoption), legally adopted by the decedent or taken in by the decedent with the intent to adopt, whether living or deceased*****
If yes, list each child (living or deceased) and each child’s date of birth:
Child’s Full Name Date of Birth
Child 1
Child 2
Child 3
Child 4
Child 5
Child 6
Child 7
If more room is needed, please include in comments section.
If decedent was married at the time of death, are all of the above children of that marriage?
Decedent’s mother’s name:
Decedent’s father’s name:
Are all of the above children 18 years of age or older?
********If NO, stop here and consult a title officer or attorney for further instructions********
Are all of the above children still living?
****If NO, then explain circumstances for each deceased child (please include date of death for each deceased child)********
Did decedent have any siblings?
If yes, list each sibling (living or deceased) and each sibling’s date of birth (if known):
Sibling’s Full Name Date of Birth
Sibling 1
Sibling 2
Sibling 3
Sibling 4
Sibling 5
Sibling 6
Sibling 7
Is there confirmation from the affiant that the decedent died without leaving a will? Please Select Yes No *
Is there confirmation that the decedent's estate was not administrated or brought to court? For example, if it went to court, then there was administration. When it goes to court, either the executor (with a will) or administrator (without a will) must sign off on behalf of the estate. Please Select Yes, Administered / Brought to Court No Not Administered / Not Brought to Court *
Did the decedent die: Please select Intestate (without a Will) Testate (with a Will) *
Was or will the estate be probated: Yes No Please Select
****If decedent died Testate (with a will), please provide a complete copy of the will and any documents from probate proceedings****
To the best of my knowledge, Decedent owned an interest in the following real property:
*
How was title to the property held?
Please Choose Tenancy: Survivorsip Tenancy Tenancy by the Entireties Joint Tenancy Tenants in Common Land Trust Other (please explain:) Please Select
PROPERTY ADDRESS:
LEGAL DESCRIPTION:
Any general comments or notes:
TERMS & CONDITIONS OF DOCUMENT USE
IF YOU USE THE ATTACHED DOCUMENT(S), YOU AGREE TO ALL OF THE FOLLOWING TERMS AND CONDITIONS OF USE:
User acknowledges that the above law firm and attorneys do not represent Document User, Purchaser, Seller, or Borrower in their real estate matter. THERE IS NO ATTORNEY/CLIENT RELATIONSHIP between attorneys and Document User, Purchaser, Seller, Borrower or any other person or entity. Any and all fees paid are for routine document preparation only. Fees do not include any services or opinions relating to obtaining lienholder consent, curing title problems, obtaining title insurance or policy endorsement. Fees do not include property searches, verification of legal descriptions or recording documents. Document User, Purchaser, Seller and/or Borrower acknowledge that Attorney did not provide any opinions or advice regarding title, zoning, taxes, easements, restrictions, land use, examination, adequacy of loan documents, and enforceability of loan documents, remedies or compliance. It is understood that financial statement analysis, economic forecasting, or valuation were not addressed by the above attorneys. Similarly, no opinions or advice were given regarding land use laws, usury laws, environmental laws, taxes or other similar matters. Document User, Purchaser, Seller and/or Borrower understand that if additional services are sought from any of the above attorneys, the attorneys will determine the scope of such additional services and the required fees. No additional research or investigation was requested or performed. It is understood that some documents may not be prepared without additional information obtained from Document User, Purchaser, Seller and/or Borrower. It is further acknowledged that the accuracy of the document(s) generated depends on the accuracy of the information hereto provided by Document User, Purchaser, Seller and/or Borrower. Document User, Purchaser, Seller and/or Borrower consents to documents being faxed or e-mailed to the closing location or title company office. Use of this document is authorized solely for one specific transaction. No person or entity is authorized to re-use this document for any additional matters or transactions. Courier delivery charges are the responsibility of Document User, Purchaser, Seller and/or Borrower.
IF YOU DO NOT AGREE TO THE TERMS & CONDITIONS OF DOCUMENT USE, YOU ARE NOT AUTHORIZED OR PERMITTED TO USE THE DOCUMENT. USE OF THE DOCUMENT CONSTITUTES ACCEPTANCE OF ALL TERMS & CONDITIONS OF DOCUMENT USE.
I agree to terms and conditions regarding document request: Please Select I Agree