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LENDER INFORMATION:
Officer/Processor Name:
Phone:
Company Name:
Address:
E-mail:
BORROWER INFORMATION:
Name of Loan Applicant:
Co-Applicant
:
Phone #:
Cell / Other #
:
Property Address:
City:
State:
Zip:
Type of Property:
Single Family
Agricultural
Lakeshore
Vacant Land
Condo
Duplex
Other
Legal Description
or ID Number:
Current Owner ( if sale):
Phone #:
Appraisal Type:
1004 (URAR)
UAAR ( Agricultural )
2055
2065
Vacant Land
Narrative
Certificate of Completion
Recertification of Value
Date Ordered:
Special Instructions:
Listing Agent (if known):
Agent Phone:
