STATEWIDE APPRAISAL, INC.
4526 Deer Lane, Whitelaw, WI 54247 Phone: (920)732-3018 Fax : (920)732-3073

RESIDENTIAL APPRAISAL REQUEST FORM

Borrower Name: ______________________________________________________

Address: ______________________________________________________

City: ____________________________

Zip Code: ____________________________

County: ______________________________________________________

Legal Description: ______________________________________________________

Estimated Value: ______________ Sales Price: ______________

Loan Amount: ______________

TYPE OF REPORT

( ) Sale

( ) Re-Fi

( ) 2-4 Family

( ) 1004

( ) Recert

( ) Vacant Land

( ) 2065

( ) Final Inspection

( ) Field Review

( ) 2075

( ) New Construction

( ) 704 Drive-By

( ) 2055 Ext

( ) Income

  

( ) 2055 Ext/Int

( ) Desk Review

  

PHOTO INFORMATION

( ) Subject, Street & Comps

( ) Subject Only

( ) Subject & Street

( ) No Photos

Include Interior Photos ( ) No ( ) Yes


SPECIAL INSTRUCTIONS

______________________________________________________

______________________________________________________

 


CLIENT INFORMATION

Company Name: ______________________________________________________

Company Address: ______________________________________________________

City: _____________________________

Zip Code: _____________________________

Phone Number: _____________________________

Fax Number: _____________________________

Ordered By: _____________________________

E-Mail Address: _____________________________

Investor: _____________________________

Loan Number: _____________________________

Signature: _____________________________