1268 Lincoln Avenue #210
San Jose, CA 95125
Phone: 408.995.6012
Fax: 408.995.6013
www.montgomeryappraisal.com

   
Fax Order Form
Loan Agent/Processor: _____________________________________________
Company: _____________________________________________
Address: _____________________________________________
City/State/Zip: _____________________________________________
Phone: _____________________________________________
Fax: _____________________________________________
Service Requested (Circle one):
Appraisal Order
Comp Search

Type of Appraisal (Circle one):

Full appraisal

Drive by/2055

Exterior Only

Interior & Exterior

Payment Method (Circle one):

Bill

C.O.D.

Amount$_________________________

___________________________________________________________________
Subject Information
Borrower Name: _____________________________________________
Property Address: _____________________________________________
City/State/Zip: _____________________________________________
Rental (Circle one):  Yes / No       If Yes, Monthly Rent$:___________________

Purpose (Circle one):
Purchase
Refinance

Sale Price/
Est. Value $:		 ____________
Loan Amount $: ____________
Client’s Minimum
Value Estimate $:		 ____________
(If known)
Size (ft2): ___________    # Bedrooms: _________     # Baths: ___________ 
Updating/Remodeling:     _______________________________________________________________________
Pool / Other Amenities:   _______________________________________________________________________


Access Contacts:		 ______________________ , Work Phone:___________________ , Home Phone:___________________

______________________ , Work Phone:___________________ , Home Phone:___________________
                      
(For Montgomery Appraisal Office Use Only)

File #:________ Acct Mgr.:________ Appraiser:________ Census Tract #:________ Map Code:________


Fax: 408.995.6013