Appraisal Order Form

Date Ordered: ____________________________________

Phone: __________________________________________

Company:  _______________________________________

Type of Appraisal: _________________________________

Representative: __________________________________

Sale or Refinance (Circle One)

Borrower: ________________________________________

Property Address: ________________________________________________________

City: _____________________ State:____________________ Zip Code:_____________

Contact Person: _______________________________

Home Phone # ________________________________

Cell Phone # __________________________________

His Work # ____________________________________

Her Work # ___________________________________

Purchase Price: _______________________________

Year Purchased: ______________________________

Comments: __________________________________________________________________________

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Method of Payment (Please Circle One):      C.O.D     Or     Billed