Company Name:          

Appraisal Requested By:  

Street Address:            

City/State:                  

Zip:                            

Phone & Ext.:               

Fax:                           

E-mail:                        

Property to be Appraised

Street Address:

City:                           State:

County:                          Zip:

Property Type:Single FamilyLand Only2-4 Family

                    CondominiumOther

Is this a purchase? Yes

If "Yes" what is the sales Price?

Note: If Purchase, please fax copy of the sales contract.

Is this for a refinance? Yes

If "Yes" what is the opinion of value?

Borrower Information

Who is the borrower? OwnerBuyer

Name (s):      

Access Information

Who will be responsible for giving access to the property?

OwnerRealtorOther

Name:             

Phone (Home):        

Phone (work):         

Phone (mobile):