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    CLIENT/MORTGAGE BROKER:

    NAME: *

    COMPANY: *

    PHONE NUMBER: *

    EMAIL ADDRESS: *

    APPLICANT:

    NAME: *

    PHONE NUMBER:

    EMAIL ADDRESS:

    PROPERTY TO BE APPRAISED:

    ADDRESS: *

    City: *

    PURPOSE OF APPRAISAL:

    PURCHASE:

    MLS:

    YesNo

    Private:

    YesNo

    Purchase Price:

    REFINANCING:

    YesNo

    Estimated Value:

    OTHER:

    LENDER:

    Same As Above? YesNo

    NAME: *

    COMPANY: *

    EMAIL ADDRESS: *

    APPRAISAL REPORT TYPE:

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