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Mike Shirley REA-Residential Real Estate Appraisal Services

Online Appraisal Order Form

Order Info		* *Indicates a Required Field*
Order Date*	Loan No.
From*	E-Mail*
Phone*	Fax*
Lender*
Address*
City*	State*		Zip*
Delivery Method*
Property Info
Property Address*
City*	State		Zip*
Borrower's Name*	Property Type*

Loan Info
Price (Estimated Value)*	Sale/Re-Fi
Loan Type*
Access Info
Contact*	Name*
Phone*	Work Phone
Home Phone	Cell
Other	Fax

Billing Info
Fee	Method

Payment is expected C.O.D. Unless billing arrangements have been made with the appraiser.
Special Instructions
Please insert any special instructions in this area.