Subject Information:

Street Address
City
State/Province	MN
Zip Code

Borrower or Owner:

Name(s)

Contact to Gain Access:

Name
Work Phone	(Including area code)
Home Phone	(Including area code)

Client Information:

Name
Organization
Street Address
City
State
Zip code
Work Phone	(Including area code)
FAX	(Including area code)
E-mail

Appraisal Report Needed (Common Report Types):

1004 URAR 1073 Condominium 2055 Exterior Inspection FHA 1004 URAR FHA Condominium 1025 Small Residential Income Property 2070/2075 Condition and Marketability Report 2000 Field Review Completion Report
(The fee quoted is for non-complex properties.  Complex properties may warrant a higher fee)

Transaction Type:	Refinance Purchase PMI Removal Other
Occupant:	Owner Tenant Vacant
Date Needed:
Estimated Value:

 Special instructions or information

*Click here to print a copy before submitting the request*  Please fax any related documentation to 763-755-8844