INVESTORS TITLE INSURANCE COMPANY
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INVESTORS TITLE INSURANCE COMPANY
REINSURANCE QUESTIONNAIRE
All questions on this form must be completed or marked ‘N/A.’ Failure to complete the form in its entirety may result in a delay of approval.
1. Issuing Office/Agent:
Contact Person:
Contact Phone Number:
2. Commitment No. Agent’s File No.
3. Has underwriting approval been obtained for this transaction?
Yes No
From: Date:
Was the coverage amount established at that time?
Yes No
Were issues raised in underwriting approval and have they been addressed? (Describe the issue raised and resolution or requirements made):
4. Project Name:
Project Type: Commercial - Office Commercial - Retail Apartments
Industrial Residential Residential – Tract Multi-Family
Other:
5. Brief description of transaction and use of loan proceeds:
6. Property Location:
(Address or City, County, State)
7. Loan Type: Construction - New Construction - Perm
Purchase Refinance Modification
Other:
8. Is this a reissue or extension of policy which has been previously insured?
Yes No
If yes, show previous reinsurance number or indicate when and what the amount was of previous policy and policy number:
9. Has insured specified reinsurer(s)? Yes No
If yes, who and how much?
10. Has insured requested approval of reinsurer(s) prior to closing? Yes No
If yes, show name, address, phone number and email address of person to be contacted:
RISK INSURED
1. Check type of policy to be issued and indicate year and amount of coverage:
A. ALTA Owner’s:
B. ALTA Loan:
C. Leasehold Owners:
D. Leasehold Loan:
E. Construction Loan:
F. Other:
2. Identity of proposed Insured and type of entity (Individual, Corporation, General Partnership, Limited Partnership, LLC, Trust, REIT, Other – Please specify):
Owner:
Lender:
Leasehold Owner:
Leasehold Lender:
3. Is this a construction loan? Yes No
A. If yes, will date-down endorsements be given?
Yes No
B. Will the construction loan be assigned to a permanent financing lender?
Yes No
C. Have we agreed to insure the perm loan?
Yes No
D. Name of lender for permanent financing:
4. Will a mechanic’s lien exception be placed on the policy?
Owner: Yes No
Lender: Yes No
If no, basis for coverage (If basis is an indemnity, please attach copy of form to be used):
5. If this is a hospital or health care facility, were any Hill-Burton Funds used on the project?
Yes No N/A
6. Are there any extra-hazardous risks involved in this transaction?
Timber, Oil, Gas or other minerals, title to which has been severed
Air Space or Air Rights issues
Tidal or submerged lands or lands which abut a navigable waterway
Native American (tribal) lands
Railroad property or property abutting a railroad right of way
Mechanics Lien Coverage – where insuring a transaction involving construction or recently completed construction
Removal of any Exclusion from Coverage contained in the policy
Lien priority based on a subordination of lien or mortgage
Title based on a judicial proceeding (tax sale, condemnation, bankruptcy)
Title based on foreclosure or deed in lieu of foreclosure
Water Rights
Other
If other, please explain:
7. Are there any unusual aspects involved such as outstanding air rights, outstanding mineral rights, wrap-around mortgages, severance of improvements, sale-leaseback, etc.?
Yes No
If yes, explain here or at end of form:
8. If there are any special exceptions or notes on Schedule B, explain reason for same:
9. Is this transaction controlled business (e.g. is the policy being issued to or on behalf of a lender, developer, owner, Insured or any other person where any such persons have an ownership interest in or other indirect-control of the agent, employee or other person involved in the issuance of the policy?)
Yes No
If yes, please explain:
10. A. What endorsements are to be attached to policy?
Zoning Usury
Non-Imputation Inflation
Navigational Servitude Fairway
Revolving Credit Mineral Rights coverage including
ALTA 9 Series damage to improvements
Interest Rate Swap First Loss
Tie-In (Cluster) Access
Other:
B. What is basis for giving endorsement?
C. Was there a special premium for the endorsement?
Yes No
11. Is there a current survey of the property?
Yes No
If yes, are there any specific items of note disclosed in the survey?
Yes No
Describe:
If no, is one being obtained prior to closing?
Yes No
Please attach copy of the commitment to this questionnaire.
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