Information for appraisers

Company Name: *

Appraiser First Name: *

Appraiser Last Name: *

Business Address

Address: *

City: *

State: * Please Select… Alaska Alabama Arkansas American Samoa Arizona California Colorado Connecticut D.C. Delaware Florida Micronesia Georgia Guam Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Marshall Islands Michigan Minnesota Missouri Marianas Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Palau Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Virgin Islands Vermont Washington Wisconsin West Virginia Wyoming

Zip Code: *

Physical Address (if different from above):

Address:

City:

State: Please Select… Alaska Alabama Arkansas American Samoa Arizona California Colorado Connecticut D.C. Delaware Florida Micronesia Georgia Guam Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Marshall Islands Michigan Minnesota Missouri Marianas Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Palau Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Virgin Islands Vermont Washington Wisconsin West Virginia Wyoming

Zip Code:

Office Phone: *

Mobile Phone: *

Primary Email Address: *

Secondary Email Address:

Licensed (list states):

Certified (list states):

Certified General (list states):

Professional Designations:

How many years appraising? Less than 2 years 2-10 years 10+ years

Have you been subject to disciplinary action? Yes No

Please explain:

Are you able to deliver reports in Mismo/XML? Yes No

UAD compliant? Yes No

FHA approved? Yes No

Please list which states:

VA approved? Yes No

Please list which states:

Which area(s) are you proficient in? 2-4 Family Properties Land Appraisals High Dollar/Complex Assignments Manufactured Homes Review Work

Number of years of appraising in your current market: Less than 2 years 2-10 years 10+ years

Are you a member of any professional peer groups? Yes No

MLS Memberships (please list):

Number of years experience in hybrid work: Less than 2 years 2-10 years 10+ years

Have you performed review work for other AMC firms? Yes No