Order Customer Service

Instructions: Please complete all fields under "Client Information." To complete "Kit Information," our customer service department needs specific instructions regarding "Farming Area/Address." At least one "Type Of Property" must be marked. Complete "Delivery Information" is required.

Additionally, orders may be faxed to 928-753-6339. If you have any questions, please contact our customer service desk at 928-753-6300 or send email to custserv@statetitleagency.com.

Client Information

Date:

City/Branch:

Bullhead City Kingman Lake Havasu City Parker

Customer:

Company:

Address:

City:

State:

Postal Code:

Phone #:

Fax:

Cell Phone:

Email:

Kit Information

Please Check All That Apply

Farming Area/Address:

Farm Kit (Includes ownership information)

Labels

Maps

Comps

Type of Property

Single Family

Vacant Land

Commercial

Mobile Home

Property Profile (Includes property information, comps, maps, liens, vesting deed, taxes)

Address:

Or

Parcel Number:

Or

Legal Description:

Miscellaneous

Vesting Deeds

Taxes

Delivery Information

Date Due:

Pick Up

Deliver to Address:

Fax to Number:

Email to Address:

Other Information

If the person submitting this form is not the client, please supply your name and email address below so that a State Title Representative is able to contact you regarding this inquiry.

Name:

Email:

Please provide any additional information that may help us in processing your request.

Submit to State Title

In the box labeled 'Security Code', please enter the garbled text that appears in the image below. This helps us ensure that your request is genuine and not an engineered attack on our website. Security Code: