Integra Appraisal Services
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Request (PURCHASE)
Date Received/requested
File Number
*Date needed by
*Borrower/Purchaser
*Property Address
Legal Discription
LOT: BLOCK: SECTION: SUBDIVISION:
*Contact Name
Contact Information
Home Phone: Work Phone: Cell Phone:
*Purchase Information
Sales Price: Loan Amount: Sales Concessions: Date of Sale:
*Client Information
Address: Phone Number: Client Loan Number: Proccesor:
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