Westmoreland Allegheny Apprasial Order Form

If you wish to contact us by e-mail, fax, phone or letter please contact us at:

IRELAND REAL ESTATE & APPRAISAL SERVICES

P.O. Box 145

Ardara, PA 15615

(724) 863-7370 - Main
(724) 863-3597 - Fax Email: Laurametz@myway.com

Ordered By:
Lender/Client (User of the report):
Lender's Street Address:
City/State/Zip:
Lender's Phone:	() -
Lender's Fax:	() -
Lender's Email:
Email Appraisal To (if different):
Customer Name:
Property Street Address:
Property City/Sate/Zip:
Contact Person:
Home Phone:	() -
Work Phone:	() -
Cell Phone:	() -
Real Estate Agent:
Agent's Phone:	() -
Pay by Credit Card: Visa, MC, Discover:
Credit Card #:
Credit Card Exp. Date:
Purpose of Appraisal (i.e. purchase, refinance, etc.):
Purchase Price:
Estimated Value:
Source of Estimated Value:
Total Loan Amount:
Special Instructions:
Legal Description:
Type Appraisal Ordered: 1004 Full (2005 New Form), 2055 Exterior w/ comp photos, Multi 2-4 Units, 2055 Interior w/ comp photos, 1004 Exterior (2005 New Form), Condominium (2005 New Form)

Ireland Real Estate & Appraisal Services