Appraisal Request Form

Datacomp Appraisal Services 2600 5 Mile Rd NE Grand Rapids, MI 49525 ( 800 ) 365-1415

( 800 ) 841-8062

( 800 ) 365-1415

fax :

phone :

email :

Ordered by

Phone # : Fax # :

Email Address :

Client Ref # :

Company :

Location :

Contact Person :

Lender

Name : Comp Appraisal NADA Appraisal

Home Inspection Only

Other :

Comparable Appraisal with Comp PhotosAddress :

City / State / Zip :

Home Address Information

Address Where Home is Currently Sited

Street / Lot #:

Community :

Is this Home to be Moved? Yes No

City : State : Zip : Private Property Retailer Lot

Address Where Home is Being Moved to ( ll this in only if home is being moved )

City : State : Zip : County :

Make :

Model :

Selling Price ( No Tax ) $ :

Renance Balance :Serial # :

Year / Size :

Home Sale Information

AM Phone : PM Phone :Owner :

AM Phone : PM Phone :Occupant :

AM Phone : PM Phone :Buyer Name :

AM Phone : PM Phone :Retailer :

Ask For :Key at Retailer Sales Oce

Home Information

Special Instructions

Contact Information

Sale Listing Renance Insurance

Other:

Appraisal Request Form