DIRECTLY ISSUED POLICY FORM
(This form or the T-00 MUST be attached to each Home
Office Policy submitted for signature)
File #: ___________________
Policy #: ____________________
County: ________________________
Policy Information:
(1)
(2)
(3)
(4)
(First National will key this data from the policy)
Location of insured land identified by the standard three (3) digit county
code;
Gross Premium and limits of liability on each policy;
Date of Policy;
Transaction identification number (File Number)
First National Agent Issuing Policy:
Name: _____________________________________________________
TDI Firm ID #: ___________________________________________
Cooperating Agent/Agent Furnishing Title Work:
Name: _____________________________________________________
TDI Firm ID #: ___________________________________________
Reason for Directly Issued Policy/DIP Status Code (please check one):
□
Best Evidence
□
Multi-County
□
Out of County
Please send the policy(ies) with this form attached to:
First National Title Insurance Company
2400 Dallas Parkway, Ste. 580
Plano, TX 75093
You may direct questions to 1-888-944-3684
Note: POLICIES CANNOT BE PROCESSED WITHOUT THIS SHEET OR THE T-00