Name                 Company Name
Street Address                    City 
State/Zip                Phone #
Fax                                      E-Mail

SUBJECT PROPERTY / LOAN DATA

Name of Borrower
Sales Price
Property Street Address
City      Parish
State/Zip
Legal Description
Lot Dimensions/acres

TYPE OF APPRAISAL REQUIRED

Please describe the type of appraisal which you require.  (Example, Full FNMA Appraisal, 2055 Internal Inspection, 2055 External Only, FHA, RECD, Land Only Etc.)

CONTACT PERSON

If a Realtor is involved:
Company
Name 
Phone

Person to contact for inspection 
Your Home Phone Number 
Your Work Phone Number 

FEE

How would you like to be billed for our services?
Collect in full from borrower Collect half fee on inspection/rest on closing Bill us upon completion (Other)

note:  the company ordering this appraisal is responsible for the fee reguardless of the loan result.

Please contact me as soon as possible.