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Client Name:
Client street address:
Client City:
Client ZIP:
Client Phone:
Client Fax Number:
Client Email Address:
Buyer Seller Realtor
Realtor Name:
Company Name:
Realtor Phone:
Fax Number:
Cell:
Pager:
Realtor Street Address:
Realtor City:
Realtor ZIP:
Type of Structure, etc: Home Townhouse
Property Address:
City:
ZIP:
1 Story 2 Story Basement Crawl Slab Occupied Vacant
Approximate Sq. Ft:
Age:
Who will attend inspection?:
Desired Date:
Desired Time:
Buyer Seller Realtor
How is the property accessed?:Lock box Open Realtor Client
Are utilities on?:Yes No
Is house occupied or vacant?:Occupied Vacant
How were you referred to us?:Internet Yellow Pages
Realtor (name):
Friend (name):
Fees range from $200. We will provide you the fee amount when we confirm the inspection.We look forward to serving you. We will be happy to answer any questions and schedule an inspection time that is good for you. Please call us at (770) 619-2952.