ORDER FORM
Haida Appraisal
813 S. Illinois
Belleville, Illinois 62221
phone
618-235-9910
fax
618-235-9909
Please fill out as much information as possible.
Assignment Information
Due Date
Case #
Order #
Form/Type
(None Selected)
Unknown
URAR 1004
Drive-By 2055
Interior 2055
Full Appraisal
FHA
Form 2065
In House
!
Loan Type
(None Selected)
Conventional
FHA
FSA/RHS/FmHA
Other
Purchase
Refinance
VA
Sales Price
$
Ordered By
Loan Amt
$
!
Lender
Est Value
$
!
Parcel ID #
Property Taxes
$
!
Date Last Sold
Sq. Footage/Lot Size
Property Information
Address
*
!
Prop Type
(None Selected)
Attached
Condominium
Cooperative
Detached
Duplex
Other
Project Under Development
Quad
Single Family
Triplex
Vacant Land
Vacant Lot
City
*
!
Legal Desc
Postal Code
*
!
Contact and Access Info
Occupancy
(None Selected)
New Construction
Owner
Tenant
Vacant
Borrower
Home
Work
Mobile
Pager
Fax
Email
Home
Work
Mobile
Pager
Fax
Email
Co-Borrower
Home
Work
Mobile
Pager
Fax
Email
Home
Work
Mobile
Pager
Fax
Email
Appointment Contact
(None Selected)
Borrower
Co-Borrower
Occupant
Other
Owner
Realtor
Home
Work
Mobile
Pager
Fax
Email
Home
Work
Mobile
Pager
Fax
Email
Additional Comments or Instructions to Appraiser
© 2004 Haida Appraisal, Inc. All rights reserved.
design work
www.midamericaweb.com
