Are you the:

Property Buyer Property Seller Buyer's Agent Seller's Agent Other

Desired inspection date:

-- mm/dd/yy

Desired inspection time:

Morning Mid-day Afternoon

How will access be gained at the above time:

Listing Agent Selling Agent Owner Buyer Lock Box Not Sure

Type of inspection:

Single Family Home Townhouse Duplex Condominium Commercial Partial Mobile Home Siding/Stucco New Construction - Phase I New Constrcution - Phase II New Construction - Phase III New Construction - Phase IV New Home Warranty Mold Other

Buyer/client information and address of property to be inspected:

First Name
Last Name
Address
Address (cont.)
City
State
Zip
Work Phone
Home Phone
E-mail

Approximate square footage of house:

< 1,000 1,000 - 1,200 1,201 - 1,400 1,401 - 1,600 1,601 - 1,800 1,801 - 2,000 2,001 - 2,250 2,251 - 2,500 2,501 - 3,000 3,001 - 3,400 3,401 - 4,000 4,001 - 4,500 4,501 - 5,000 5,001 - 5,500 5,501 +

Approximate age of home:

0 - 30 years 30 - 60 years more than 60 years

Number of HVAC units:

1 2 3 4 5 6 More

Additional items to be inspected:

Pool or Hot Tub
Sprinkler System
Pier & Beam
Out Buildings

Is the house vacant?

Yes No

Are the utilities on?

Yes No

Who will be attending the inspection:

Buyer(s)
Seller(s)
Selling Agent
Listing Agent
Other

Selling Agent (optional):

Name
Organization
Work Phone
Home Phone
FAX
E-mail

Listing Agent (optional):

Name
Organization
Work Phone
Home Phone
FAX
E-mail