Lender/Client Contact Information
   -----------------------------------
        Business Name:    
      * First:            
      * Last:             
      * Address 1:        
        Address 2:        
      * City:             
      * State:            
      * Zip:              
      * Email:            
        Phone:            
   
   Property Information
   -----------------------------------
      * Address 1:        
        Address 2:        
      * City:             
      * Zip:              
   
   For property entry contact:
   (Complete if different from lender/client info)
        Name:             
        Phone:            
   
   Type of Report Requested
   -----------------------------------
    Single family full appraisal (1004 Form) ...... $250
    Condominium appraisal (1073 Form) ............. $250
    Limited Summary Appraisal (2055 or 2065 Form) . $200
    Multi-Family Report (1003 Form) ............... $350
    FHA Appraisal ................................. $300
    Field Review (2000 Form) ...................... $225
    ERC Relocation Appraisal ...................... $350
    Vacant Land Appraisal ......................... $250
    Draw or Final Inspection ...................... $75

   Referral
   -----------------------------------
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