Missouri Land Title Association



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Application

Membership Dues

Organization

Organization Name:

Number of Licensed Employees:

Total Number of Employees:

Senatorial District:

State House District:

U.S. House District:

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Organization Email Address:

Organization Web Site Address:

Primary Contact Person

First Name:

MI:

Last Name:

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Type of Membership

Individual

Sole Proprietorship

Fictitious Name (d/b/a)

Attorney

Corporation

C Corp

S Corp

P.C.

Partnership

General

Limited

Limited Liability

Limited Liability Company

Organization Address Information

Address 1:

Address 2:

City:

State:

Zip Code:

Missouri County (if applicable)

Phone:

Fax:

Membership Category

The undersigned hereby makes application for membership in the Missouri
Land Title Association under ONE (1) of the following categories as defined
in the By-laws of the Associates.

CHOOSE ONLY ONE (*Requirements shown below)

Active

*Missouri Agency License Number:

Underwriter License Number:

*Underwriter Appointments: (Check ALL that apply.)

Chicago Title Insurance Company

Commonwealth Land Title Insurance Company

Farmers National Title Insurance Company

Fidelity National Title Insurance Company

First America Title Insurance Company

Guarantee Title Insurance Company

Land Title Insurance Company of St. Louis

Lawyers Title Insurance Company

Old Republic National Title Insurance Company

Stewart Title Guaranty Company

TICOR Title Insurance Company

United General Title Insurance Company

Affiliate

*Primary Business: (non-title agency)

*Vendor Primary Product:

Retired

*Last Title Industry Experience/Employer:

If you have any questions about joining please contact our executive director Pam Hart, or any of the officers or directors.

In order to qualify as an active member, you must (a) be actively involved in the business of title assurance, (b) have a title insurance license issued by the State of Missouri, (c) have a place of business open on a regular basis and (d) agree to abide by the Code of Ethics and the bylaws and rules of the Missouri Land Title Association.

After your application is submitted and a deposit equal to one years dues is made, the application will be submitted to the board for approval at the next regular board meeting.