GORDON APPRAISAL SERVICE, INC.

FAX APPRAISAL ORDER FORM
SIMPLY PRINT OUT THIS FORM, FILL IT OUT AND FAX IT TO US AT 217-234-4666.
TO PRINT PRESS CTRL+P OR PUSH THE PRINT ICON ABOVE.

ORDER DATE:______________________

COMPANY:_____________________________________________________

COMPANY CONTACT:___________________________________        PHONE:____________________________________

PROPERTY ADDRESS:_______________________________________________________________

CITY:________________________________________

OWNERS:__________________________________________________________________________

PHONE NUMBERS:        HOME:________________________________    WORK:___________________________________

BORROWER:__________________________________________________________________

PHONE NUMBERS:        HOME:________________________________    WORK:___________________________________

FORM USED:        1004     2055/INTERIOR      2055/EXTERIOR     OTHER

    PURCHASE     REFINANCE

OTHER:     COMMERCIAL    APARTMENT    DUPLEX     OTHER

PAYMENT:        COD BY BORROWER        BILL US

COMMENTS:____________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________

REAL ESTATE AGENT:___________________________________________

PHONE NUMBERS:    WORK:____________________________    CELL:_______________________________

CONTRACT INCLUDED WITH ORDER?    YES    NO

FOR OFFICE USE ONLY:

ENTRY INSTRUCTIONS:___________________________________________________________________________________
________________________________________________________________________________________________________

DIRECTIONS TO THE PROPERTY:__________________________________________________________________________
________________________________________________________________________________________________________

FILE NUMBER:____________________________