Palm Appraisal Group LLC
151 N. Orlando Ave #131, Winter Park, FL., 32789
phone: (407) 628-1012    fax: (407) 628-1282

Complete the five sections below to place your order.

1Client Information

Firm or Individual Name:
Address:
Suite / Bldg / Mail Stop:
City: State: Zip:

Contact Name:
Telephone: Fax: Email:
Unless otherwise specified, all reports will be delivered in PDF format to the email address indicated here. For other delivery options, please specify in the Appraisal Product section and/or Special Instructions.

Client File/Case Number: Include this number on report?:

Lender Information - If the appraisal report is to be certified to a different party than the client information specified above, complete the following section:

Lender Name:
Lender Address:

2Borrower Information

Primary Borrower Name:
Co-Borrower Name (if applicable):

Borrower Contact Telephone:
Alternate Contact Telephone:

May we contact the borrower if necessary?:

Select the type of Loan Product:

Select the applicable lien type for this loan:

Select the purpose of this loan:

For Purchase Mortgages: We will require a completed, signed copy of the sales contract in order to complete the appraisal. We will contact the client to obtain a copy of the contract unless another source for the contract is specified. If we should obtain a copy of the sales contract from another party, please specify their contact information in the Special Instructions section of this form.

3Property Information

Subject Property Address:
City: State: Zip:
County:
Subject Parcel ID (please include for vacant lots):
Property Type:

Contact For Entry / Access to Subject Property - If the contact for entry or access to the subject property is NOT the borrower, please complete the following section:

Entry Contact Name:
Contact Telephone: Alternate Telephone:

4Appraisal Product

Choose a report type:
Fee for this report (change this number only if you have already discussed a fee change with us):

Additional Report Forms & Options:

Fee for additional forms (change this number only if you have already discussed a fee change with us):

Total Fee:
(This does not include additional fees from any special requirements as indicated below. We will contact you if your final fee will vary from this number).

Specify Payment Method: Cash/Check at Door:  Credit Card:

Additional Considerations for this report (check all that apply):
REO/Foreclosure:
Hardcopy Required (add'l postal fees may apply):
State Cert. Appraiser Required (Trainees not acceptable):

Special Instructions
Specify additional requirements below. If a hardcopy is required, specify the delivery address here. Please bear in mind that some requirements may necessitate additional work and may alter the fee indicated above (we will contact you if a change in the appraisal product is necessary):

5Confirm and Proceed

Please verify the information on this form; when you are ready to proceed, click the Proceed button below. You will be redirected to our payment processing page.



©2007 Palm Appraisals and Jason E. Rock
Palm Appraisals
151 N. Orlando Ave #131, Winter Park, FL., 32789
(407) 628-1012 (v) / (407) 628-1282 (f)