Date:

Time:

Please provide the following client/company information:

Company
Address
City
Phone
Contact First Name
Contact Last Name

Please provide the following information about the property to be appraised:

Street Address
City

Borrower/Client:

Name
Work Phone
Home Phone
Cellular Phone
Pager No.

Property Class:

House Condominium Drive-By Appraisal Duplex Triplex Fourplex Apt/Bldg Highrise Apt/Bldg Residential Office Commercial Property Idustrial Property Warehouse Condo Office Building Office Condo Land Vacant Lot Land Development Limited Appraisal Restricted Appraisal

Comments:

Property Access/Realtor Access:

Name
Work Phone
Home Phone
Cellular Phone
Pager No.

Sales Price:

Mortgage Amount:

Value Estimate If Refinancing:

Special Instructions

Choose one of the following payment methods:

C.O.D. Bill Client

Fee $ :

File No.