Borrower Name   

Address                        City             

State                                                             Zip Code    

Home Phone            Work Phone        Cell  

Address of Property to Appraise

Address                        City             

State                                                             Zip Code    

Owner (If different from Borrower)       

Company ordering appraisal                 

Address                        City             

State                                                             Zip Code    

Phone                            Fax            

E-mail Address   

Name of Person ordering appraisal       

Additional comments or instructions

E-mail to send Appraisal to:           

Payment of Services    (New Customers should make payment arrangements before ordering)

    Borrower at the Door                Lender to pay within 30 days of receiving the appraisal*

*Law requires appraisal to be paid within 30 days of due date.

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