Plumb Tuckett & Associates - Request Location Report

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Please allow us a few days to get back to you. Any information you submit is used solely for in-house purposes and is not furnished to any outside party.

Contact Name: *	Order Date:

Company:	Phone Number: *

Address: *	Alternate Phone Number:

City: *	Fax:

State: *	Email Address: *

Zip: *	Date Needed By:



Property Address to be Surveyed:

City / State:

Please check all that apply:
Residential Commercial Final Elevations Needed Duplex or Multi-Unit with Property Line Division Required Other

If "Other" please provide a description below:


Mortgage Company/Lender:	Title Company:

Commitment Number:	Buyer:

How would you prefer we contact you?
By Email By Phone (primary phone first) By Phone (alternate phone first) Either is fine, I have no preference

MUST PROVIDE SCHEDULE “A” FROM TITLE WORK WITH ORDER TO INSURE PROPER LEGAL DESCRIPTION. IF THE LOCATION REPORT IS TO BE CERTIFIED TO THE TITLE CO., A COPY OF THE ENTIRE TITLE WORK IS REQUIRED. IF EASEMENTS CALLED FOR ON SCHEDULE “B” ARE TO BE SHOWN, CALLED FOR EASEMENT DOCUMENTS MUST BE PROVIDED. PER INDIANA CODE 865 IAC 1-12-27: THE CLIENT SHALL BE RESPONSIBLE FOR PROVIDING ANY TITLE DOCUMENTS OTHER THAN RECORDED PLATS OR IT WILL NOT BE SHOWN ON THE REPORT LEGAL DESCRIPTION (SCHEDULE “A” OR COMPLETE TITLE WORK MUST FOLLOW ASAP): NOTE: THIS ORDER FORM IS OUR AUTHORIZATION TO PROCEED WITH THE LOCATION REPORT. NO CONFIRMATION WILL BE SENT. IF WORK IS CANCELED, PLEASE NOTIFY US AS SOON AS POSSIBLE. THE DESCRIPTION OF THE PROPERTY AS RECEIVED, (AS SHOWN HEREON OR ATTACHED), WILL BE RELIED UPON FOR THE LOCATION REPORT. ANY CHANGES DUE TO ERRORS IN PROVIDED INFORMATION WILL BE MADE AT AN ADDITIONAL COST.

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