Appraisal Solutions 4515 W. Saginaw Hwy. Bldg. B Suite 206 Lansing, MI 48917 Ph: (517)321 - 9667 Fax: (517) 321-9678 www.appraisalsolutions.net

Mortgage Company

Mortgage Company Address

Company Phone:                                                                                Company Fax:

Ordered by

Sales price or Estimated Value $

Please Check appropriate (   ) with X.

Salel (   )     Refinance (   )     FHA  (  )     FHA Case #

COD (   )     or       Invoice  (   )

Full 1004 Appraisal (   )      Multi-Family (   )   Exterior only 2055  (   )  Desk Review  (   )   Field Review   (   )         Other

Customer Name

Property Address

City                                                           Zip Code                                                      County

Home Phone No.                                            His Work No.                                                      Her Work No.

Best time to contact                                                              am / pm

Subject Property Parcel or Tax ID No.

Special Instructions

All invoiced appraisals must have signature of guarantee of payment or appraisal will not be processed.

By signing the Guarantee you understand you and your company are responsible for prompt payment of the appraisal in a timely manor( within 30 days). You also understand the appraisal is not contingent upon obtaining any specific value. Appraisal Solutions may choose not to accept any appraisal assignment for any reason. Only Appraisal Solutions may choose to alter or amend this agreement and will do so in writing.

Print Name                                                                                          Signature

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