Jeffrey A Goldin Indiana Certified Residential Appraiser
| Order Date: | Due Date: |
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| Property to be appraised: | ||
| Street Address: | County: |
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| City: | Zip Code: | |
| Borrower: | Borrower: | |
| Phone: | Cel:) | Email: |
| Property Owner: | ||
| Phone: | Cell: | Email: |
| Client/Lender: | ||
| Address: | ||
| Contact Person | ||
| Phone: | Cell: | Email: |
| Type of report: (circle) | ||
| UAD/URAR(1004) / Land | FHA | 2055 (Exterior Only) |
| Final Inspection/ Const Update | Manufactured Home O I/ Rent Schedule (216/1007) | |
| Condo (1073) / ERC (Relocation) | Field Review /Desk Review | |
| Other: | ||
| Reason for appraisal: | ||
| Listing agent: | ||
| Phone: | Cell: | Email: |
| Selling agent: | ||
| Phone: | Cell: | Email: |
| Plans and Specs: | ||
| Additional comments: | ||
| Parcel #: | Legal Description: | |
| Site Size: | Taxes: | |
| Age: | ||
| Transfer Date: $: | Prior Transfer Date: $: | |