Appraisal Order Form


Lender Information
Ordered By
Address
City
State
ZIP
Phone
FAX
Contact name and E-mail


Customer Information
Name
Address
City
State
ZIP
Home Phone
Work Phone
Mobile Phone
Real Estate Agent
Agent’s Phone


Office Information
Collects Fee Appraiser
Lender
Purpose for Appraisal
(e.g. purchase, refinance, etc.)
Purchase Price
Estimated Value
Source of
Estimated Value
Total Loan Amount
Special Instructions