Law Firm Information:

*Solicitor:	*Contact:
*Firm:	Lawyer File Number:
*Address:	*City:
*Province: British Columbia Alberta Saskatchewan Ontario Québec New Brunswick P.E.I. Nova Scotia Newfoundland Northwest Territories Yukon Territory Nunavut	*Postal Code: (no spaces please)
*Telephone: (include area code) e.g. 1-403-307-3305	*Fax: (include area code) e.g. 1-403-307-3305
E-Mail:
*Have you ordered from Stewart Title before?	Yes No
*Would you like to recieve your policy by:	Fax Email No Preference
*Lawyer/Notary acknowledges that they have obtained consent from their clients to have their personal information transmitted over the internet, being a non-secure transmission route.
*Are you/your firm acting for:	Borrower/Purchaser   Lender
Please list the names of any other solicitors acting on this transaction:

Policy Information:

*Transaction Type:	Purchase Refinancing Share Purchase (# of shares):
*Property Type:	Condominium Vacant Land Farm - Commercial
	Other (Please specify):
*Policies Required:	Lender Owner Both Gap only (policy ends upon registration)
Purchase Price:	*Closing Date:
*Interest In Land:	Fee Simple Leasehold (If Assignment of Lease: Instrument No.
	Registration Date *If this transaction involves native lands, please contact our Underwriting Department.)
	Other:

Mortgage Information:

1.	Lender:		Registered Mortgage Amount:
	Private Lender?	Yes No	Reference/Loan Number:
	Priority:	First Second Other	Construction Mortgage	VTB
2.	Lender:		Registered Mortgage Amount:
	Private Lender?	Yes No	Reference/Loan Number:
	Priority:	First Second Other	Construction Mortgage	VTB
3.	Lender:		Registered Mortgage Amount:
	Private Lender?	Yes No	Reference/Loan Number:
	Priority:	First Second Other	Construction Mortgage	VTB
4.	Lender:		Registered Mortgage Amount:
	Private Lender?	Yes No	Reference/Loan Number:
	Priority:	First Second Other	Construction Mortgage	VTB

Owner / Property Information:

*Purchaser / Borrower Name(s): (If corporate borrower/purchaser, please provide name(s) of Corporate Signing Officer(s))

Current Vendor Name(s) (If purchase transaction):

*Municipal Address of Property to be Insured:

*Legal Description of Property to be Insured:

P.I.D./Surface Parcel

Title Search Results:

1.	Existing Mortgages:
	To Be Discharged	NOTE: Private mortgages must be discharged prior to or on closing
	Remaining on Title	(Please list details below and/or fax a separate sheet where required)
	Lender:
	Date of Registration:		Instrument Number:
	Original Principal($):		Priority:                     First Second Third
	Other (Specify):
2.	*How long has the Borrower and/or Vendor owned the property?
3.	Details of ALL other Registered Instruments including but not limited to all easements, restrictions and agreements (other than subdivision, development or site plan agreements). (Fax additional explanations and / or copy of the Title when applicable):

4.	Are there other matters affecting title which you would qualify on your opinion? Yes No
	If "Yes", please explain:

Survey Information:
*Do you have a survey?     Yes No
If no survey is available, further underwriting may be necessary and you will be contacted by us.
If "Yes", please fax a copy of the survey for our review.

Does the survey disclose any defects or are you aware of any changes made since the survey date?     Yes No
If "Yes", please explain:

Off-Title Search Results:    Please refer to our commercial search requirements (available on request or on our website).

1.	*Tax Search Results -  Verbal confirmation from the Municipality, a receipt tax bill, a reference in a vendor’s/mortgager’s Statutory Declaration or Tax Certificate is sufficient for transactions under $10,000,000. For larger transactions please see our search requirements.
	Paid to Date	Arrears to be Paid from Closing Funds	Other (Specify):
2.	For SASKATCHEWAN Properties only: Writ Registry Search Results -  (search Borrower and/or Vendor, when applicable)
	Clear	Execution(s) against current parties being paid out and lifted
	Similar Name Execution(s)	Client affidavit being obtained for writs under $50K
		Solicitor affidavit being obtained for writs over $50K
3.	*Building/Zoning Search Completed? Yes No
	If "Yes", are Search Results clear? Yes No
	Use of Property:
	a)   Is the property currently under construction? Yes No
	b)   If the property is currently under construction, has a compliance search been completed for all Subdivision Agreements and Development Agreements on title?
	Yes No Will obtain (please advise of any outstanding issues) None on title
4.	*Fire Work Order Search		Yes No
	If “Yes”, are Search Results clear?		Yes No
5.	WHEN ORDERING A LOAN POLICY - Corporate Borrowing Resolution for the Borrower
	Obtained	Not yet, but will be obtained before closing	Not a Corporate Borrower
6.	WHEN ORDERING A LOAN POLICY - I have confirmed that the borrower has the authority to enter into this mortgage:
	Yes	No
7.	Have there been any recent changes (within the last 12 months) of any officers/directors?
	Yes	No
8.	Current Corporate Certificate of Status / Corporate Profile for the Borrower and/or Vendor
	Obtained	Not obtained, but will be obtained before closing	Not Applicable
9.	*Utility Search Results (to the extent that they may form a lien against the property) – Verbal confirmation from the Municipality, a receipted utility bill, a reference in a vendor’s/mortgagor’s Statutory Declaration or a Utility Certificate is sufficient for transactions under $10,000,000. For larger transactions, please refer to our search requirements.
	Paid to Date	Arrears to be Paid using closing funds	There are no arrears forming a lien
10.	Condominium Status Certificate
	Clear Certificate	Not Clear (Please fax a copy for our review)	Not Required: Refinance Under $2 Million

Answers to the below questions are on the understanding that they are completed “to the best of your knowledge” and the answers are a result of due diligence conducted in accordance with the practice standards of your professional society.

Additional Questions

1.	*Will you be obtaining Canadian/Provincial government issued photo ID from your client prior to closing and keeping a legible copy in your file?	Yes	No
	If "No", is the borrower/purchaser a long term client of yours?	Yes	No
	If "No", please explain:
2.	IF PURCHASE:  Was any portion of the deposit paid directly to the Vendor?	Yes	No
	If "Yes", please explain:
3.	IF REFINANCE:  Are the mortgage proceeds being paid to anyone other than an existing lender or the borrower directly?	Yes	No
	If "Yes", please explain:
4.	*Have there been any transfers or discharges of mortgages registered within the last 6 months?	Yes	No
	If "Yes", please explain:
5.	*Has another insurer refused to issue a title insurance policy for this transaction?	Yes	No
	If "Yes", please explain:
6.	*Are any parties signing documents by way of a Power of Attorney?	Yes	No
	If "Yes", please fax a copy of the Power of Attorney to our office for review
7.	Is a Private Lender providing the Mortgage?	Yes	No
	a) Is the subject property mortgage free? (i.e. Presently no mortgages on title)	Yes	No
	b) Is the subject property vacant land?	Yes	No
	c) Is the transfer to the borrower for nominal consideration? (If the transfer is an estate conveyance or transfer from trustee to beneficiary, or an inter-family / inter-spousal transfer, please answer "yes" to this question.)	Yes	No

Stewart Title is committed to protecting the privacy and personal information of those insured under Stewart Title policies. The information provided about them is kept confidential and used for the issuing of policies and administering any claims which may arise under those policies. For a copy of our complete privacy policy, please visit our website at www.stewart.ca, or contact our Privacy Officer at 1-888-667-5151.

For purposes of the Insurance Companies Act (Canada), this document was issued in the course of Stewart Title Guaranty Company's insurance business in Canada.

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