Client Name (company ordering appraisal):**

Client Address, City, State and Zip: **

Lender Name (if different from client): **

Lender Address, City, State and Zip: **

Client Contact Name: **

Client E-mail Address:

Client Phone: **

Client Fax #:

Borrower's Name: **

Co-Borrower's Name:

Borrower's Home Phone #: **

Property Address, City, State and Zip: **

County of Property:

Please check one: **

Purchase

Refinance

2nd Mortgage

FHA Loan             FHA case #

 

 

 

Today's Date: **

 

Date Required By: **

 

Closing Date:

 

Closing Company:

 

Purchase Price:

 

Estimated Value:

 

Legal Description:

 

Previous Sale Dates of Property:

 

Property's Parcel Number:

 

 

Please check one: **

 

1004 Single Family

Multi-Family 2-4 Plex 1025 Form

2055 with Interior and Exterior Inspection

2055 Exterior Inspection Only

Vacant Land

Other (please call first to confirm)

 

 

 

Do you need a plat? **

Yes
No

 

Sellers (if applicable):

 

Occupied By:

 

Listing Agent (if applicable):

 

Agent Phone #:

 

Person to contact for entry: **

 

Contact Phone #: **

 

Alt. Contact Phone #:

 

Additional Comments: