Part I - Request


From (Name and address)

Appraisal Solutions, Inc.

2850 Shoreline Trail # 35

Rockwall, TX 75032

Company Name


City, State & Zip Code

Company Phone Number

Company Fax Number

Name of Loan Officer

Lenders Name

Name of Borrower

Name of Co - Borrower

Address of Borrower

Address of Co - Borrower

City, State & Zip Code

City, State & Zip Code

Part II - Property and Mortgage Information

Property Type

Occupancy Status

Type of Loan

Lien Position

Loan Purpose

No. of Units :

If FHA - Case # :

Sales Price $

Estimated Value $

Loan Amount $

Property Address

Property City, State and Zip Code

Legal Description

Listing Agent

Selling Agent

Listing Agent Phone No.

Selling Agent Phone No.

Part III - Appraisal Information

Due Date:

Method of Payment

Credit Card Type

Credit Card #

Expiration Date


Type of Appraisal

Contact Name:

Contact Phone 1:

Contact Phone 2:

Contact Phone 3:

Additional Comments / Notes

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