Florida Appraisal Source

Residential Real Estate Appraisals

         Office: (352) 797-0600   Fax: (352) 797-8017

                                                                                 Appraisal Order

Ordered By_____________________ Ph_______________ Ext____

Email__________________________________________________

 Company Name__________________________________________

Address________________________________________________

City_______________________ State_____ Zip__________

Phone______________________ Fax________________________

FEE $_________   p COD        p Credit Card Visa/MasterCard

 Homeowner or Borrower___________________________________

 Property Address_________________________________________

City_______________________ State_____ Zip______________

Contact #’s: Home_________________  Work__________________

Cell_____________________ Other__________________________

Property Type: p Single Family    p Condo   p Manufactured Home

                             p Other __________________________________

 Form Requested:    p Full Appraisal-1004    p Condo 1073 

          p Exterior Drive-by  2055         p Other______________

p Purchase: Sale/Contract Price $___________________________

p Refinance: Estimate of Value $____________________________

p Primary Residence p Second Home p Investment Property

Contact for Access________________________________________

_______________________________________________________

Appraisal to be emailed to__________________________________

 What web site did you here about us from______________________

 Credit Card Payment:    p Visa        p MasterCard

Name on Card___________________________________________

Card Number_________-___________-_________-_____________

Exp Date ____/____Card Billing Address______________________ ______________________________________zip_______________

19514 Cortez Boulevard, No.220, Brooksville, FL 34601