CLOSE
INSPECTION REQUEST FORM
Client Information
Your Name:
*
Home Address:
*
full address
Phone:
*
Cell:
Fax:
Email Address:
*
Property Information
Address of Property to be Inspected:
*
City:
*
Preferred Date of Inspections:
*
January
February
March
April
May
June
July
August
September
October
November
December
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
2012
Time:
1
2
3
4
5
6
7
8
9
10
11
12
AM
PM
Structural Information
Type of Home:
*
Single Family
Townhouse
Condominium
Commercial
Square Footage:
Sq. Feet
Age:
*
New
1 to 10
11 to 20
21 to 30
31 to 40
41 to 50
51+
Years
Client's Realtor
Sold by Owner?
No
Yes
Realtor Name:
Realty Company:
Additional Comments: