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Client Data: (* required fields)
*Requested by:			*Phone:
Lender/Company:			Fax:
Address:			*Email:
City:			State:
Zip:			Loan File #:
Property Information:
Property Type: (check one)	Single Family 2-4 Family Condo Vacant Land Commercial Industrial Other
*Property Address:
City:			State:
Zip:
Owner:			Borrower:
Sale Price:
Prior Appraisal File #:
Access Information:
Owner/Representative:
Phone (home):			(work):
(cell):
Listing Realtor:			Phone:
Report Requirements:
Report Purposes: (check one)	Purchase Refinance Home Equity New Construction Inspection FHA Review Other
Report Type: (check one)	1004/70 URAR 2055 Exterior 1004C/70B Manuf. Home 1073/465 Condominium Old 2055 Form Home Equity & Non Secondary - Interior Old 2055 Form Home Equity & Non Secondary - Exterior Other
Payment Method:
Pick up Check @ Door		Bill Client (only for approved clients)
Special Instructions:
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2003© Martin + Wood Appraisal Group, Ltd.   43 S. St. Clair Street  Toledo, OH 43604
419-241-4998 or toll-free 1-800-999-0251