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First Name:	*	Last Name:	*
Company:	*	Email:	*
Address:	*	City:	*
State:	*	Zip Code:	*
Phone:	* For phone and fax, please use numbers only with no hyphens or parenthesis. e.g.: 3105551212	Fax:

Property Information:
Address:	*	City:	*
State:	*	Zip Code:	*
County/City:	* There is an additional $50 trip charge for Counties/Cities marked with ¹

Appraisal Information:
Format:	* Appraisal Format Information
Purpose:	² If other, please specify in comment area. *
Purchase $:	If known, please specify purchase price for subject property.	Purch. Date:	If known, please specify purchase date for subject property.
Concessions:	If know, please specify seller´s concessions.
Owner Occ.:	*If the property is owner occupied, please select "Yes". If it is an investment property, select "No".	New Construction: *Is the property a new construction?
Rush:	*Is this a rush appraisal? If so, please specify the date needed by on the next field.	Date Needed by:
Comments:
Payment:	*Payments for appraisals are due at the time of inspection or prior to.

Property Contact Information:
Contact:	* Please select who we need to contact to gain access to the property. ²If other, please specify in the comment area above.
First Name:	*	Last Name:	*
Phone:	*	Home:
Mobile:		Email:

Mailing Information:
Address:	*All appraisals when completed are emailed in PDF format. An additional fee is assessed for hard copies mailed.	City:	*
State:	*	Zip Code:	*

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