Appraisal Request Form

Lender/Client Info		Property Info
	Request Date:		Applicant Name:
	Originator:		Contact Name:
	Lender/Client:		Property Address1:
	Client Address1:		Property Address2:
	Address2:		City, State, Zip:
	Client Phone:		Contact Phone:
	Client Email:		Style of Property:
	Client Fax:		Number of Units:

Sale Price or Estimated Value of Property**:

**Your estimated value is for your convenience only and totally voluntary. This estimated value will not be used

by the appraiser in determining the appraised value and should not be supplied to the appraiser with such intentions.