REQUESTER                                                                                                                                          **required fields
                                                                                                                     
**Contact Name Lender Name

**Street Address  **City

**State **Zip **Email Address

**Tel.  Fax Alt.Tel.

Report Format -Select- PDF/email Hard copy Other Delivery Email Address (if different than above)

Loan Officer/Processor Loan/File/Order/Case #

SUBJECT PROPERTY INFORMATION

Borrower Name(s) Property Type -Select- Single Family Condominium Townhouse, fee simple Manufactured Home Duplex/Triplex/Fourplex Vacant Lot/Land Apartment Other

Street Address City

State    Zip      County

Legal (lot/block/section/subdivision)   

Contact for Entry (name) Tel. Alt. Tel.

Loan Type -Select- Conventional FHA Bank Other Report Type -Select- Complete (URAR/1004) 2055 Interior 2055 Exterior Only 2070/2075 Exterior Only Condominium 2 to 4 Family Other

Purpose of Appraisal -Select- Purchase Refinance Cash-out Refinance PMI Removal Relocation Set Sales Price Estate/Divorce Other Report Due Date

Contract Sale Price $ Loan Amt $ Estimated Value $

Collect from Borrower (COD)? -Select- No Yes **Payment Method -Select- Cash Pay Pal Approved Account Credit Card MO / Cashier's Check Other

*If paying by credit card or PayPal, finish entering your order and "Submit,"
then use the "Download Forms" button to get the necessary form.

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           sent to us electronically. We will contact you within
           24 hours to confirm receipt of the order.

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