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Client Information

* Date Ordered ______________________ * Due Date __________________________

* Contact Person/Loan Officer_____________________________________________

* Company ____________________________________________________________

* Address _______________________________ * City __________________________

* State ___________________ * Zip Code______________________________________

* Phone # _____________________________ * FAX # _________________________

* Email Address ____________________________________________________________

Property Information
* Property Type: ____ SFR, _____ Condo, _____ 2 - 4 Units

Other ____________________________________________________________________

* Form Type:____ 1004 ____ Condo ____ 2055 (interior) ____ 2055 (exterior/driveby)

Other ____________________________________________________________________

* Borrower: ______________________________________________________________

* Property Address: ______________________________________________________

* City ______________________________________ Zip Code ___________________

Purpose of the Appraisal

________Sale  Sale Price _______________________________________

Refinance Estimated Value $ ______________________________________________

Loan Amount ____________________________LTV ______________________________%

Other_____________________________________________________________________

Property Access Information

* Contact Person 1	Home Phone	Work Phone	Cell Phone
Contact Person 2	Home Phone	Work Phone	Cell Phone