Lender Contact Person:

Lender Loan Number#:

Loan Amount:

Phone#:

Fax#:

Borrowers:

Lot#:

Tract#:

Plan#:

Type of appraisal needed please check one: Conventional FHA
If you checked the FHA box please give us the FHA case number:

Sale Price:

Refinance: Owners estimate of value:

Access Person: Phone#:

New Construction: Base Price:

Total Sale Price:

Sales Concessions: Date Of Sale:

Special Instructions: