A.C. Real Estate Appraisal Services, Inc.
P.O. Box 186
Lake Placid, Fl. 33862

Phone:(863) 699-1433
Fax:(863) 699-1438
Email: acappraisals@earthlink.net

Company: _______________           _______________________________________
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Phone:  _____________________________
Fax:     _____________________________

Form: Full (1004) ______  Land ______  2055 Ext. ______  Final ______

Borrower: ___________________________________________________________
Property Address: _____________________________________________________
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Legal Description: _____________________________________________________
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Sales Price/Owners Estimate of value: ______________________________________
Loan Amount: ________________________________________________________

Entry Contact: ________________________________________________________
                            
Date Needed By: ______________________________________________________

Comments: ___________________________________________________________

COD: __________                      Bill To: ____________________________________