Crime Application

Application

Applicant(s)

Include all trade names and insured's

Applicant

Address(es)

Include all locations, if there is more than one

Address

City

State

Zip

Telephone*

Email Address*

Organization Description*

Proprietorship

Partnership

Corporation

LLC

Title Agency*

Yes

Year Operations Began*

Law Firm*

Yes

Year Operations Began*

Have you operated as a title agent under any other name in the past 3 years?*

Yes

Please provide the other name(s) under which you operated*

Has there been an ownership or management change in the past 3 years?*

Yes

Please give the details surrounding the change*

Any losses known or reported in the past 3 years?*

Yes

Please provide the explanation(s) for the losses*

Are all locations secured by an alarm system?*

Yes

Do all locations contain a safe?*

Yes

What is the number of employees who handle, have custody of, maintain records or, or have access to money, securities, or other property owned by you or your clients?*

What is the number of outside messengers?*

Current Coverage

Carrier

Limit

Deductible

Expiration Date

Fidelity Carrier

Fidelity

Fidelity Limit

Fidelity Deductible

Fidelity Expiration Date

Surety Carrier

Surety

Surety Limit

N/A

Surety Expiration Date

Scope of Financial Statement Preparation*

Internal

CPA Compilation

CPA Review

CPA Audit

None

Insuring Agreements Coverages

Choose overall limit*

$250,000

$500,000

Coverage

Limit of Insurance

Employee Dishonesty

$0.00

Forgery or Alteration

$0.00

Computer Fraud

$0.00

Funds Transfer Fraud

$0.00

Fraudulently Induced Transfers

$0.00

Do you deposit and disburse funds for Closing and Settlement?*

Yes

Are funds deposited in a trust account separate from operating accounts?*

Yes

What is the average daily escrow (trust) account balance?*

Does the file contain loan closing and documentation of compliance with instructions?*

Yes

Are all escrow or trust funds reconciled by an independent party on a monthly basis?*

Yes

List and explain any discrepancies*

Are you periodically audited by the title companies you represent?*

Yes

Are all incoming checks stamped "For Deposit Only" immediately upon receipt?*

Yes

Are bank accounts reconciled and controlled by…*

The Owner

The Employees

Does any Employee(s) have authority to execute a wire transfer?*

Yes

Is the ability limited to specific employees?*

Yes

Have authority for wire transfers outside the United States?*

Yes

N/A

Are there dual control procedures in place so that one Employee doesn't control a transaction from start to finish?*

Yes

Explain your screening procedures*

Do you have any procedures to verify the identity and authenticate new customers before entering into a transaction with them?*

Yes

Please explain your screening procedures*

Do you accept wire transfer instructions from customers over the telephone, fax, email, or some other electronic communication method?*

Yes

Please explain your procedure to authenticate the instructions*

Do you verify the following

Do you investigate new customers through a credit reporting agency?*

Yes

Do you verify and confirm the customer's bank account information (account numbers, routing numbers, bank name and address) by calling the bank directly?*

Yes

Do you verify requests to change the customer or funds recipients' bank account information or wire instructions by calling the customer or funds recipient at a telephone number previously provided by the customer or funds recipient?*

Yes

Do you verify the amount requested to be transferred equals the amount due to the customer or funds recipient?*

Yes

Do you accept and verify wire transfer instructions from your employee, officers, and owners over the telephone, or by fax, email, or some other electronic communications method?*

Yes

Please explain your procedure to authenticate the instructions*

Is there a written policy regarding wire transfers?*

Yes

Do wire transfers to an account outside the United States require review and approval by a supervisor?*

Yes

Is the authority to execute wire transfers limited to specified employees?*

Yes

What is the average daily dollar amount of wire transfers?*

What is the single largest amount that can be transferred?*

What is the average monthly number of fund transfers?*

Do you provide anti-fraud training, including social engineering, phishing, masquerading, and other fraud schemes, to all employees?*

Yes

Do you restrict customer information access to only a particular employee?*

Yes

Do you control access to customer information in your computer systems?*

Yes

Do you implement access controls and firewalls in your database of customer information?*

Yes

Do you restrict access to only particular employees of yours?*

Yes

Do you require the customer to authenticate his or her identity by using passwords, personal identification numbers, shared secrets, tokens, or biometrics before the customer may access his or her data?*

Yes

Do you control the dissemination of customer information?*

Yes

Do you have a company policy prohibiting the dissemination of personally identifiable information pertaining to the customer?*

Yes

Do you provide customer information only to a designated representative of the customer?*

Yes

Do you require the customer requesting customer data to authenticate his or her identity by using passwords, personal identification numbers, shared secrets, tokens, or biometrics before the customer may access his or her data?*

Yes

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