Client / Lender Data

Company Name:		Contact Person:
Mailing Address:		City:
State:	AL AK AZ AR CA CO CT DE DC FL GA HA ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC TN TX UT VT VA WA WV WI WY	Zip:	-
Street Address:		City:
State:	AL AK AZ AR CA CO CT DE DC FL GA HA ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC TN TX UT VT VA WA WV WI WY	Zip:	-
Position of Contact Person:		E-mail Address of Contact Person:
Phone Number:	-- Ext.	Fax Number:	--
Other client contact information; i.e., loan officer's name and phone number, processor's name and phone number, etc.:

Borrower Information

Loan Number:
Borrower Name:	Last:	First:	MI:
Co-Borrower Name:	Last:	First:	MI:

Property Details

Street Address:		City:
State:	NC SC	Zip:	-
Legal Description:	Lot:	Block:	Section:
Subdivision or Condo Project name:		Tax Map Number (if known):
Other identifying information:

Type

URAR – Full Single Family          FNMA 1004, FHLMC 70	FNMA 2055 (DU Quantitative)          Interior & Exterior
FHA URAR Single Family	FNMA 2055 (DU Quantitative)          Exterior Only
Condo – Full Condo          FNMA 1073, FHLMC 465	FHLMC 2055 (LP Quantitative)          Interior & Exterior
FHA Condo	FHLMC 2055 (LP Quantitative)          Exterior Only
Land Appraisal	FNMA 2065 (DU Qualitative)          Interior & Exterior
Multi-Family (2-4 Family)          FNMA 1025, FHLMC 72	FNMA 2065 (DU Qualitative)          Exterior Only
Satisfactory Completion Cert.          FHLMC 442	FHLMC 2070 (LP Condition & Marketability          Interior & Exterior
FNMA 2075 (DU Underwriter          Property Inspection Report)	FHLMC 2070 (LP Condition & Marketability          Exterior Only
Operating Income Statement          FNMA 216, FHLMC 998	Construction Progress Report/          Draw Schedule
Rent Schedule          FNMA 1007, FHLMC 1000	.

Property Access Information

Contact (Realtor) Name:	Last:	First:
Home Phone Number: --	Work Phone Number: --	Cell Phone Number: --
Other contact information (who to contact, additional access information, etc.):
Important: Please fax copy of sales contract and / or instructions for obtaining plans & specs.

Reason for Appraisal

Sale	Sale Price:		LTV:
Refinance	Loan Amount:		LTV:.
.	Owner's Estimate of Value:
Other (Please specify reason for appraisal; divorce, estate, etc.)		Please Specify:
(If appraisal is for an estate or divorce, please provide the date of death or date of separation:		Date of Death or Separation:

Appraisal Details

Date Ordered:		Date Needed:
Note: Additional fee may be charged for rush appraisal.

Delivery Instructions

E-mail (preferred method)	E-mail Address :
U.S. Mail	Number of Copies:
Other	Specify other:
The above-referenced company (Company), through its undersigned authorized representative, requests the above-referenced appraisal from Certifax Appraisals. Company agrees to pay for said appraisal in full within 30 days of invoice date regardless of whether any underlying loan/transaction closes. Company agrees to be responsible for a monthly $15.00 late fee for all past due invoices for the first 90 days of delinquency. Thereafter, Company agrees to be responsible for a monthly $50.00 late fee until paid. Company agrees to be responsible for paying all attorney’s fees and costs incurred by Certifax Appraisals in collecting any unpaid balance whether incurred before or after the filing of an action. Company agrees jurisdiction and venue shall be in Horry County, South Carolina.