Flagroup.com valuation request form

1) Client Contact Information *Required Fields are marked in the asterisks () symbol**
Company:
Contact Name *:
Street Address *:
City *:
State or Province *:
Postal Code/ Zip *:
Country *:
Telephone *:
Fax:
E-Mail Address *:

2) Purpose of Valuation:
Refinance/Purchase/PMI/Others:
Refinace	Purchase	PMI Remove	Portfolio Check
Purchase Price (if purchase):
Repo	Estate	Litigation
Or Value Estimate (if Refinance):
If this is a purchase, we will need a copy of the purchase agent and any amendments faxed to us.
FHA or Conventional (USA only):
FHA number (if FHA):

3) Property Identification
Residential		Commercial		Industrial

Street Address:
City:
State and Zip:
Legal Description:
Sales Price or Estimate of Value:

4) About the Property
Number of Rooms:
Number of Baths:
Approximate Square Feet:
Approximate Age:
Construction:
Type of Roof:
Garage:
Lots Size:
Acreage:
Landscaping:
Patio/Sunroom/Deck:
If has a Pool:	Above Ground
	In-Ground
Fireplace:	Yes
	No
Other Improvements:
Will subject property be occupied at time of closing:
	Yes
	No