PERSON ORDERING:____________________________________ DATE:_____________________
CLIENT/LENDER NAME:_________________________________ PHONE:____________________
CLIENT ADDRESS:______________________________________ FAX:______________________
CITY, STATE & ZIP:_______________________________________________________________
EMAIL FOR REPORT:______________________________________________________________
REPORT REQUESTED: 1004/FULL 2055/INT 2055/EXT ONLY 2075/DRIVEBY (no value)
LAND SRIP CONDO OTHER_______________
PROPERTY ADDRESS:______________________________________________________________
CITY, STATE & ZIP:_______________________________________________________________
PROPERTY OWNER’S NAME:______________________________ PHONE:___________________
BORROWERS NAME:____________________________________ PHONE:___________________
CONTACT FOR INSPECTION:_____________________________ PHONE:____________________
If property is being sold by realty company, please provide listing and selling agent names and phone
numbers.
LISTING AGENT:_______________________________________ PHONE:___________________
SELLING AGENT:_______________________________________ PHONE:___________________
PURCHASE PRICE:___________________________ EST. VALUE:___________________________
LOAN AMOUNT:_____________________________ TYPE OF LOAN:_________________________
Please provide any known information such as lot size, home style, square footage, basement, view, etc.
_______________________________________________________________________________
PAYMENT: Pre-pay by client / Collect at inspection
CLIENT SIGNATURE: ____________________________________ DATE:____________________
This appraisal will be performed for the sole and exclusive use of the above client. Appraisal will be
performed to estimate the market value of the above property. It will be assumed that the above
property has fee simple interest, if otherwise please advise. The appraisal will be prepared in accordance
with the Uniform Standards of Professional Appraisal Practice. A Statement of Limiting Conditions and
Appraiser’s Certification will be attached to all appraisals prepared by this office.
Provide a PDF or EDI Email address (above) or overnight shipping company and account number if you
would like report sent differently.
Thank you very much for your business.
APPROVED