Appraisal Request
Date:
Ordered By:
Borrower Name(s):
Subject Property Address:
Zip Code:
City: State:
Legal Description (if available):
Contract Price:
Date Signed:
Mortgage to Property:
Access to Property:
Phone # (1):
Phone # (2):
Name of Lender/Client:
Address of Lender/Client:
City:
State: Zip Code:
Phone # :
Facsimile # :
E-Mail Address:
Purpose of Appraisal:
Loan Type:
Order Number:
Type of Dwelling:
What appraisal form are you requesting?  (select only one)
1004 Single Family Interior/Exterior Form (Revised 3/05)
1073 Condo Form Interior/Exterior (Revised 3/05)
1025 Multi-family Form
2055 Exterior Only Single Family
1075 Exterior Only Condo Form
1004C Manufactured Home Form
1004D Completion/Update
Other  Specify:
Rent Schedule Operating Income Statement?
Yes
No
Yes No
Lender has collected appraisal fee?
Appraiser will collect fee at time of inspection?**
Yes No
**Note that a copy of the report can be provided to the borrower at their request when the fee
is collected from the borrower. Please advise if you do not wish the borrower to have a copy.
Method of Delivery: (Select one of the following)
Hand Delivery
U.S. Mail
Overnight Delivery
E-Mail Address:
If overnight delivery is selected, indicate the preferred company and the account number:
UPS Federal Express
DHL
Account Number:
Additional Information: (If applicable)