Company Name
Street Address
City
State and Zip Code
Main Contact Person
Broker Name
Business Phone
Fax Number
Brokers Email Address
Contacts Email Address
Banking Information
List all people authorized to sign checks (Copy of signers drivers license is required)
Title Company Information
Name of Title Company
Name of Title Rep.
User Information
List the full names of all personnel to be trained on software
Current Virtual Escrow Status
Is your Company currently using Virtual Escrow?	Yes
	No
If Yes, do you require additional training?	Yes
	No
If Yes, what Trust Bank are you using?
If Yes, who was your Virtual Escrow Sponsor?
Important Lane Guide Information
The Virtual Escrow system contains proprietary data licensed from Lane Guide. The license agreement with Lane Guide requires that each subscribing broker office (physical address) be a licensed user of Lane Guide. At the time of application your information will be forwarded to Lane Guide. After you have closed your first escrow using Virtual Escrow Technology, your broker code will be submitted as an active broker and you will receive a Lane Guide CD-ROM. Directly from Lane Guide. This CD-ROM contains all lender data nationwide, including wholesale lender search capabilities. We recommend you install this CD as a reference to locate additional lenders not found in the Virtual Escrow system. Please be advised that subsequent annual renewals will be billed to you directly from Lane Guide. Failure to maintain your Lane Guide subscription (license) may result in discontinuance or limited access to the Virtual Escrow software or systems. If you are already a current (paid) Lane Guide subscriber, please indicate your Subscriber No. Here:
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*Real Estate Brokers as well as California Financial Lenders, Banks, Savings and Loans, Insurance Companies and Credit Unions qualify to perform an escrow on any transaction they are a party to. Copyright, Virtual Escrow-Title Technology Solutions, LLC, All rights reserved

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