Central State Appraisal Services

* = Required Fields

Retail Lender

Wholesale Lender

* Lender Company Name
Address
City, State
* Phone Number
Fax Number
Processor or Loan Officer Name
Processor or Loan Officer e-mail address

Lender Company Name
Address
City, State
Phone Number
Fax Number
Processor or Loan Officer Name
Processor or Loan Officer e-mail address

Borrower Name
Property Street Number
Street Name
City
County
State
Zip Code

Appraisal to be in the name of: Wholesale Lender Retail Lender

Contact Name
Contact Phone Number
Legal Description


Alt Contact Phone Number
Special Instructions

Loan Type

	Conventional
	FHA

Property Type

	Single Family
	Multi Family
	Condo
	Co-Op
	Mixed Use
	Commercial
	Industrial
	Vacant Land

Request Type

	Full Appraisal 1004/1025/1073
	Drive By 2055
	Final Inspection
	Other
	If Other:

Bill		Borower		Lender	Amount $
Billing Info:

Card Type
CC#
First Name		Last Name
Expiration: mm/yy		CVV/CVC#

Lender agrees to be responsible for payment within 30 days
* (Only required if Bill Lender is selected).

* has engaged Central State Appraisal Services, to provide an appraisal report on the property located at stated above
which conforms with the Uniform Standards of Professional Appraisal Practice, and all applicable Real Estate Appraisal licensing laws for the state in which this property is located.