CLTA Record Owner Guarantee 15

Record Owner Guarantee

Order No. __________

Liability ____________

Fee $ ______________ [Guarantee No. _____ ]

1. Name of Assured:

2. Date of Guarantee:

The assurances referred to on the face page hereof are:

That, according to the Company's property records relative to the following described land (but without examination of those Company records maintained and indexed by name):

The last recorded instrument purporting to transfer title to said land is:

Documentary Transfer Tax $_______________

If information was requested by reference to a street address, no guarantee is made that said land is the same as said address.