Title Guaranty Division

Application for Title Guaranty

Request for

Commitment

Certificate

Property Information
Property Address
Property City
Property State
Property Zip

Type of Property
Residential
Bare Land
Commercial, Industrial, Agricultural

Other Information (check only those that apply)
Cash Transaction
Installment Contract
Refinance/Form 900
Refinance/Abstracting
Construction Loan
End Loan
Rental Property
Mortgage(Other)

Buyer(s)/Borrower(s)
Seller(s)

Coverage and Amount
Lender 1st Mortgage	$
Lender 2nd Mortgage	$
Owner's Coverage	$
Purchase Price	$
Elligible for Free Owner's Coverage? Yes No

Lender Information
Lender Name
Lender Address
Lender City
Lender State
Lender Zip

Guaranteed Information
Guaranteed Name
Guaranteed Address
Guaranteed City
Guaranteed State
Guaranteed Zip

Lender Endorsements
	1st	2nd
a) Comprehensive 1
b) Condo (ALTA 4.0)
c) EPA-Environmental (ALTA 8.1)
d) Gap
e) Location (ALTA 22.0)
f) Manufactured Home (ALTA 7.0)
g) PUD (ALTA 5.0)
h) Variable Rate (ALTA 6.0)
h) Other

Contact for further information
Contact Name
Contact Company
Contact Phone
Contact Email
Contact Fax

Deliver Commitment/Certificate to
Deliver Name
Deliver Address
Deliver City
Deliver State
Deliver Zip
Deliver Email
Deliver Fax

Deliver Owner's Certificate to
Address Above
Owner

Bill To Information
Bill To Name
Bill To Address
Bill To City
Bill To State
Bill To Zip

Once you have completed the application form, please print a copy and send via fax (515-725-4931) or email (TGDCommitments@iowa.gov) to Title Guaranty along with a copy of the preliminary and/or final title opinion and Composite Mortgage Affidavit.