Appraisal Request Submission Form
Jon S. Curry, Appraiser
2070 Champlain Drive
Boulder, CO 80301
Phone (720) 205-5554
Fax 303-664-1221
Pager 303-266-0483
Mortgage Company Info
Mortgage company name
Clarion Mortgage
Mountain Pacific Mortgage
Hometown Mortgage
Other company - fill in below
Company name if Other
Procesor name
Mortgage co street addr
Mortgage co city
Mortgage co ZIP
Mortgage co e-mail
Mortgage co phone
Borrower Info
Select the appraisal type
1004 (Conventional)
1004 (FHA)
Condo
2055 (Interior/Exterior)
2055 (Exterior)
2075
2070
Property street
Property apt# if any
#, Unit
Property city
Property ZIP code
Property legal description
Borrower name
Contact name, if different
Borrower home phone
Borrower work phone
Property sales price
$
Property est. value if refi
$
Property mortgage amt
$
Method of billing
COD
Bill account
Credit card
Special instructions
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