Lender/Client: COD:

Lender Address:

Phone #                   Fax#   

Loan #         Loan Officer:

E-Mail Address

Assignment (Select One)

  Other:

Property Type (select one)

 Property Address:

City: State:   Zip:   County: Pasco Hernando Pinellas Hillsborough Citrus Sumter

For purchases, please provide purchase price $

sales contract are required for all purchase please fax to 727-863-9400 or e-mail it to coteapp@coteappraisals.com

For refinances, borrowers value estimate: $       

For refinances original purchase date: purchase price:   

1st mortgage amount: $   2nd mortgage amount: $

Borrower/Contact Information

Contact (select one)

Contact Name (if other than the borrower)

Appraisals is needed by: Any seller concession:

Comments/ Special Instruction:

Pasco-Pinellas-Hernando-Hillsborough

Fee Schedule

Citrus-Sumter

Fee Schedule

** Please call for a quote on atypical and jumbo properties**

**Fee are subject to change based on complexity or atypical assignments**

I would like the following:   

	0 1 2 Screen Cleaners         0 1 2 Magnets
	0 1 2 Pens
	0 1 2 Mouse Pads