FrickTrent, PLLC
141 Providence Road STE 110
Charlotte, NC 28207
Phone: 704-376-8181
Email info@fricktrent.com

Title Request Form

If you would like to submit the information below via fax instead, then please download our title request offline form.

Be assured that all information submitted here is safe and secured.

Borrower's Name *		Spouse's Name
Property Address *		County *
Phone Number *		Fax Number *
Purchase Refinance
Seller's Name		New Lender *
Loan Amount *		Requested By *
Company Name *		Company Phone Number *
Company Fax Number *		Company Email Address *
Existing Mortgage Info
Existing Mortgage (1)
Phone Number (1)		Fax Number (1)
Existing Mortgage (2)
Phone Number (2)		Fax Number (2)

Verification Code		Please type the code (letters/numbers) seen on the image to the left into the text box below. This verification code is necessary to prevent spam.

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