Request for
Policy Approval

To:	STEWART TITLE
Email: HighLiPolicy@stewart.com
Fax: (646) 525-3596

From 	     
Name 	     
Agency	     
Address	     
	     
Email	     
Voice No.	     
Fax No.	     

Property Address:      
	     
Tax Map ID:	     

Re:	Title No.:      

Policy Amounts to be issued
	Owner 		$      
	Leasehold	$      
	Mortgage	$      
	Other		$      

Proposed Insured
Owner:		     
Lessee:	     
Mortgagee:	     

The attached Certificate and Report of Title for the captioned transaction, which includes copies of all proposed endorsements and proposed affirmative insurance coverage, is herewith submitted for approval
The search was run from     ,to     
(If not a full length search, this must be explained).
The search was conducted by:
	 another agency	 our employee		 independent examiner

Prior insurance:	Company:        Date:     
Title Number:     
Policy Amount: $       Owners      Loan	 Other
Attached is a copy of	 Survey	 Protraction
one of the following:	 Tax Map	 Other

Type of premises:
 Residential 1-4 ramify	 Co-op Building
 Residential 6+	 Mixed Use (specify)     
 Condo Unit	 Commercial
 Co-op Unit	 Industrial
********************************AREA BELOW THIS LINE FOR UNDERWRITER USE ONLY*********************************
     

STEWART TITLE
By:	 Date: 		

Request for Policy Approval	page 2
	Select the correct answer	
1. Is there any indication that the seller/owner may be insolvent?		
2	Does the transaction involve a deed in lieu of foreclosure?		
3. Does the transaction appear to be bona fide, for full value?		
4. Is title derived from one of the following (check where appropriate):		
	Tax Foreclosure             Bankruptcy    Estate				
	Adverse Possession       Divorce         Forfeiture				
	Mortgage Foreclosure    Bar Claim				
If yes to any of these, have the proceedings been fully reviewed?		
5. Is the property near or crossed by a tidal or navigable body of water		
or wetlands?				
6. Do the premises abut a legally opened street or highway?		
7. If the transaction is a Construction Loan, have you required all		
Mechanics' liens to be discharged before authorizing any advance?				
8. Is there a survey of the property?		
9. Has the survey been reviewed and has exception been taken for any		
gores, boundary disputes, easements, encroachments, etc.?				
				
10. Does the survey agree with the tax map?		
11. Does the survey agree with the record description?		
12. Is the property in an Indian Claim Area?		
13. Does the transaction to be insured involve Transferable Development		
Rights (TDRs), negative covenants or easements of light and air?				
The following are other special conditions, unusual or special risks, affirmative insurance, reinsurance requirements, or other matters to be considered:

     

The Company's written consent to issue, or increase the amount of, any title assurance beyond the limits set forth in the Underwriting Agreement is required prior to issuance of such title assurance. The Company's written consent is also required, regardless of the liability amount, whenever the title assurance to be issued involves a situation where a dispute as to title exists or where unusual or extraordinary title risks are concerned.
Approval for issuance of the herein requested title assurances is subject to the terms hereof and the provisions of the Underwriting Agreement. Such approval in no way alters the liability of the parties as set forth in the Underwriting Agreement as to the losses or claims arising out of issuance of such title assurances.

The matters noted on the reverse side of this request form, together with the documents accompanying this Request, have been reviewed and issuance of the above described title assurance is recommended.
Agency:
By:	 Date: