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2. Person Requesting Information:*
4. Address*
6. City*
7. State*
8. Zip*
10. E-mail Address*
11. Phone Number
12. Fax: Number
14. Date Requested
15. Closing Date
17. First Name of Owner
18. Last Name of Owner
20. Address or Parcel Number of Property to be Searched*
22. Understanding of Payment Due *

    1. Yes, I understand

    I understand that a fee is due for any completed lien search for a property, and that if additional lien searches are requested for the same property after 30 days, that a $25 fee is due for each search.

24. Legal Description
26. Block Number*
27. Lot Number*
28. Subdivision*
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit Submit and Print

* indicates a required field