NOTE: Fields marked with * are required

CLIENT INFORMATION
Your name:	*	Your e-mail:
Company name:		Your phone #:	*
Street Address:	*	Your fax #:
City:	*	State: *	Zip: *
SUBJECT PROPERTY INFORMATION
Borrower's name:		Sales Price:
Property Address:	*	Estimated Value:
Property City:	*	Loan Amount:
Property Zip:	*	Contact Person:
Property County:		Contact Phone:
Property Type: (Please Select One) 2-4 Family Residential Income Commercial Condominium Industrial Multi-Family Nursing Home Personal Care Home Single Family Residential Townhouse Vacant Land Other - Please explain *		Appraisal Purpose: (Please Select One) Bail Bond Determine Listing Price Determine Purchase Price Divorce Estate Home Equity Loan Mortgage - Conventional Mortgage - FHA Mortgage - Reverse Opinion of Market Value PMI Cancellation Relocation Tax Purposes Other - Please explain
Appraisal Form: (Please Select One) Uniform Residential Appraisal Report (URAR Form) 2-4 Family Residential Income Report (Form 1025) Condomimium (Form 1073) Employee Relocation Council (ERC) Land Appraisal Report (Form FW 68) Quantitative Analysis Appraisal Report (Form 2055 with interior inspection) Quantitative Analysis Appraisal Report (Form 2055 with exterior inspection) Quantitative Analysis Appraisal Report (Form 2065 with interior inspection) Condition and Marketability Report (Form 2070 - no value estimate) Property Inspection Report (Form 2075 - no valus estimate) Satisfactory Completion Certificate (Form 442) FHA Compliance Inspection Construction Draw Report Other - Please explain
Method of Payment: (Please Select One) Cash, Money Order, or Certified Check at time of inspection Invoice (must have established account) Wire Transfer Funds Other - Please explain *
Method of Delivery: (Please Select One) Regular Mail UPS Overnight Mail Electronic Delivery (Adobe Acrobat PDF) Use my overnight account Other - Please explain