Central State Appraisal Services

* = Required Fields

* Lender Company Name
* Address
* Phone 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

Owners Estimate of
Value/Sale Price

Mortgage Amount

Legal Description

* Contact Name
* 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
	Drive By
	Final Inspection
	Other
	If Other:

* Lender agrees to be responsible for payment within 30 days
Bill Mortgage Company	$	Bill Borrower	$

* has engaged Central State Appraisal Services, to provide an appraisal report on the property located at
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.