Title Insurance Order Form

P.O. Box 7 • 215 North Lake Avenue Phillips, WI 54555 Phone: 715-339-2196 Fax: 715-339-4664

170 North 4th Avenue Park Falls, WI 54552 Phone: 715-762-3258

Limited Liability Partnership | Slaby Deda LLP

Slaby Deda Law Offices are issuing agents for Old Republic. Access the Title Insurance Premium Rate Calculator. If you would like to order title insurance, please complete this form, and return it to the law office.

P.O. Box 7 • 215 North Lake Avenue Phillips, WI 54555 Phone: 715-339-2196 Fax: 715-339-4664

170 North 4th Avenue Park Falls, WI 54552 Phone: 715-762-3258

TOLL FREE: 1-800-543-6440

Limited Liability Partnership Slaby Deda LLP