OWNER'S POLICY REJECTION FORM
Date: |
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GF Number: |
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Title Company: |
Madison Title Agency, LLC |
Seller: |
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Purchaser: |
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Pursuant to requirements of Article 9.55, Insurance Code, as amended, the undersigned hereby acknowledges that a Loan Policy to be issued in File No. __________________ in consideration of $____________________ premium is to be issued to the lender and that such policy does not afford title insurance coverage to the undersigned in the event of a defect in the title to the real estate which is being acquired. An Owner's Policy in the amount of $_______________ shall be issued for an additional premium cost of $______________________ unless rejected hereby.
The undersigned hereby rejects the issuance of said Owner's Policy.
UNDERSIGNED PURCHASER:
BY:________________________________