Virtual Escrow software

Registration Form

Contact First Name		Contact Last Name
Contact Phone		Contact E-mail
Broker First Name		Broker Last Name
Broker Cell Phone		Broker E-mail

Company Name		D.B.A. if any
Address		Address
Company Phone		Company Fax

List of name(s) for all personnel you wish to show as authorized signers on your Trust Account

List of name(s) for all people to be trained, or have access to the system. (Passwords assigned)

Have you used Virtual Escrow™ in the past?	Yes No	Previous Escrow Experience?	Yes No
Preferred Title Rep		Preferred Title Company
Will you be processing both Refinance and Resale Transaction or both?		Refi Resale Both