If you prefer to complete this form and send it via facsimile, please print and fax to 821-0087. Please fax all contracts, addendum and inspection reports.

assignment information

* indicates required fields     Due Date File # Loan Type* (none selected) Conventional Purchase Conventional Refinance FHA Purchase FHA Refinance Other Form/Type (none selected) Unknown 1004 Full/URAR 1004 URAR FHA 2-4 Family Comparable Rent Schedule Condominium Desk Review ERC 2055 Exterior 2055 Interior Fannie 2075 Field Review Progress Inspection Conventional Final w/ Photos FHA Final Ordered By* Sales Price $ Your email* Loan Amount $ Lender* Estimated Value $ FHA # Fee $

property information

Address* Zip* City* Property Type (none selected) Condominium Cooperative Duplex Other Quad Single Family Triplex Vacant Land Vacant Lot State*

contact information

Occupancy (none selected) New Construction Owner Tenant Vacant     Borrower Contact # Co-Borrower Contact # Appointment Contact Contact # Contact Title (none selected) Borrower Co-Borrower Occupant Owner Other Listing Agent Selling Agent

additional comments or instructions for appraiser

process request

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