Wirth Appraisal Service


Leon Wirth


Appraisal Request Order Form

Please fill in the following information, and I will contact you as soon as possible

Ordered By:
Your Name:
Client:
Address:
City:
State:
Zip:
Phone:
Fax:

Property Type:
Borrower's Name:
Property Address:
City:
State:
Zip:

Loan Purpose:
Sales Price:
OR
Estimated Value:

Contact Person:
(if different from borrower)
Firm Name:
Phone Number:
Form Type:
If you have any questions on form type, please contact the appraiser at 262-742-3450.
Special Comments:
Thank-you for your business!
W5446 Hillview Road, Elkhorn, WI 53121
Bus/Fax: (262) 742-3450
© 2005 Wirth Appraisal Service