MICHIGAN LAND TITLE ASSOCIATION
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|MICHIGAN LAND TITLE ASSOCIATION |
|Affiliated with American Land Title Association |
|124 W. Allegan, Suite 1700 |
|Lansing, MI 48933 |
|PHONE: 517-374-2728 ∙ FAX: 517-908-0079 |
|e-mail: ED@ |
|website: |
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|APPLICATION FOR MEMBERSHIP |
|(Please Print or Type) |
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|Business Name: |
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|Business Address: |
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|City: County: State: Zip: |
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|Telephone No.: Fax No.: |
|Email: _________________________________ Website: _______________________________ |
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|Applicant is: Incorporated Sole Proprietor Partnership |
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|If Incorporated, Date of Incorporation: |
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|State of Incorporation: |
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|Active Officers, Proprietors or Partners, and Owner: |
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|Name: Title |
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|Name: Title |
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|Name: Title |
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|Name: Title |
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|Owner’s Name: |
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|Applicant is applying for membership as: (See Bylaws, Article III.) |
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|□ Abstractor/Agent/Associate □ Associate Member □ Underwriter |
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|Primary County Served: |
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|Other Counties Served:: |
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|MLTA Application for Membership |
|Page 2 |
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|Agent(s) (Please check the underwriters that apply to you.): |
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|AmTrust Title Insurance Co. |
|Chicago Title Insurance Co. |
|Commonwealth Land Title Insurance Co. |
|Fidelity National Title Insurance Co. |
|First American Title Insurance Company |
|Investors Title Insurance Co. |
|North American Title Insurance Company |
|Old Republic National Title Insurance Co. |
|Stewart Title Guaranty Co. |
|Westcor Land Title Insurance Co. |
|WFG National Title Insurance Co. |
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|My sponsor’s name and contact information is: |
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|I hereby irrevocably waive any claim or right of action at law or in equity that I might have at any time hereafter against MLTA, its officers, |
|directors, committee members or employees, either as a group or as individuals, for any official act in connection with the business of the Association |
|and particularly in: |
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|a. admitting or failing to admit me, my firm, or corporation to membership; and |
|b. disciplining me as a member for infraction of the Code of Ethics, Standards or Professional Conduct, Bylaws, or regulations. |
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|Signature of Applicant: Date: |
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|Printed Name of Applicant: |
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|RETURN THIS COMPLETED APPLICATION WITH THE FOLLOWING ITEMS: |
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|1. APPROPRIATE DUES FOR THE CURRENT YEAR (see Invoice for Dues) |
|2. COPY OF LICENSE BY STATE OF MICHIGAN |
|3. PLEASE VERIFY THAT SPONSOR NAME IS LISTED ABOVE. |
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|MAKE CHECKS PAYABLE TO |
|Michigan Land Title Association and return to: |
|Michigan Land Title Association |
|124 W. Allegan, Suite 1700 – Lansing, MI 48933 |
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|Or fax to MLTA: (517) 908-0079 |
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MLTA Membership
Dues Invoice
Dues are for July 1, 2019 – June 30, 2020 (1 Year)
Michigan Land Title Association
124 W. Allegan, Suite 1700
Lansing, MI 48933
P: (517) 374-2728 | F: (517) 908-0079
Main Contact: ____________________________ Ph: ______________________
Company: _______________________________ F: _______________________
Address: ________________________________________________________________
City, State, Zip: __________________________________________________________
Email: __________________________________________________________________
Website: ________________________________________________________________
Credit Card – online
Check - Please make checks payable to MLTA and send payment with dues invoice to:
Michigan Land Title Association | 124 W. Allegan, Suite 1700 | Lansing, MI 48933
This MLTA dues billing covers membership from July 1, 2019 to June 30, 2020
MLTA dues are 100 % dedu to June 30, 2020
MLTA dues are 100 % deductible. The MLTA pays the proxy tax for the membership benefit of having 100% dues deductibility.
Agent(s): Please select the underwriters that apply to you:
θ Commonwealth Land Title Ins. Co. θ Chicago Title Ins. Co. θ Fidelity National Title Ins. Co.
θ First American Title Ins. Co. θ Investors Title Ins. Co. θNorth American Title Ins. Co.
θ Old Republic National Title Ins. Co. θ Stewart Title Guaranty Co θWestcor Land Title Ins. Co.
θ WFG National Title Ins. Co. θ AmTrust Title Ins. Co.
Primary County Served: ___________________________________________________________________
Abstractor/Agents & Associates
Gross Revenue for Preceding Year MLTA Dues Gross Revenue from Title Services MLTA Dues
Amount for Preceding Year Amount
θ Under $100,000 $143.00 θ $1,300,001 to $1,600,000 $1,125.00
θ $100,001 to $150,000 $210.00 θ $1,600,001 to $1,900,000 $1,272.00
θ $150,001 to $200,000 $268.00 θ $1,900,001 to $2,200,000 $1,406.00
θ $200,001 to $300,000 $313.00 θ $2,200,001 to $2,500,000 $1,545.00
θ $300,001 to $500,000 $450.00 θ $2,500,001 to $2,800,000 $1,674.00
θ $500,001 to $700,000 $593.00 θ $2,800,001 to $3,400,000 $1,709.00
θ $700,001 to $900,000 $723.00 θ $3,400,001 to $4,000,000 $1,861.00
θ $900,001 to $1,100,000 $847.00 θ $4,000,001 and up $2,084.00
θ $1,100,001 to $1,300,000 $995.00
Underwriters Associate Member
θ $3,859.00 (minimum) θ $300.00
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