Fill out if Different From Above:
Lender Name (to go on report)
Address State Zip Code

Borrower Information:
Borrower Name
Address to be appraised
City State Zip Code
Home Phone Number
Work Number
Cell Number

Purpose for Appraisal: (check one)
Refinance
Purchase (need signed purchase agreement)
Other

*please note for new construction or Remodel please click on and fill out the specification part of the form below.

Sales Price: $
Listing Agent Name and Number(s), if purchase

Requested Form Type:

Notes:

Specifications Sheet click here to fill out specification sheet.

(We need the following information to complete a new construction appraisal) Electrical Amps: Heat Type Forced Air HTWTR Radiant  Other: Fuel Natural Gas Liquid Propane Electric Oil Other: Air Condition Central  Individual Unit Water Source- Private Well City Septic- Mound Private City Landscaping- Final Grade Only Custom: Driveway surface: (if not going to finished by closing, please put gravel or dirt) Siding material: Gutters/Downspouts: None Steel Plastic Aluminum Other Windows: Double Hung Casement Glider Other Storms Screens Combination Garage: Attached Detached Heated  # of Stalls: Additional Outbuildings: BASEMENT: List of rooms: Full Partial Crawl Space Slab Basement Finish: sqft. Basement ceiling material: Basement wall material: Basement floor material: Walk-out: Yes or No Main Floor: Carpet Wood Tile Vinyl Other: Wall material: Tub/shower Wainscoting Fiberglass Tile Other: Interior Door Type (i.e. solid- oak- six paneled, etc.): Trim style & material (i.e. Colonial- Oak or Princeton- Maple): Fireplace(s) # and location: Deck Patio Porch Other Fence: Chain Link Wood Other: Pool: Indoor Outdoor Above Ground Below Ground View: Woods Fields Street Valley River Lake Other: Date lot purchased & Price: Additional features that add value (i.e. in-floor heat, whirlpool, central vacuum, etc.), please list all items: