To Be Determined Package Order Form

Applicant's Information

This is an electronic form used to submit your request for a To Be Determined Order. The basic fee for processing and delivering this information is $100.00 (includes 1-hr Free research). A 2.9% credit card processing fee plus $0.30 will be added at the time of payment. The initial charge will be $100.00 plus $2.90 (2.9% of $100) plus $0.30 for a total of $103.20. Once intitial payment for basic charge has been verified, the information that you provided will be forwarded for processing and your document(s) will be sent via E-mail, FAX, or Address provided. Any additional hourly research will be billed and invoiced to your provided address at $125.00 per hour.

Date of Request

Need by Date
Click in box for Calendar

Applicant's Name

Applicant's Address
Street:
City:
State:
Zip:

E-mail

Phone

FAX

Company NameUse 'NA' if individual

Property Details

Owner's Name

Property Address
Street:
City:
State:
Zip:

Legal Description
If available

Special Instructions
Optional

Tax Parcel/
Schedule #

Add Tax Certificate?YES

Delivery Method E-mail FAX Address

Confirm & Pay

After clicking on the Submit & Pay button, you will be sent to the payment page. You will have a choice to pay with a variety of credit cards or the popular PayPal system.