Order Termite Inspection

You may use this form to order WDI (Wood-Destroying Insects) Reports for Real Estate Transactions.

(* indicates required items)

Realtor Information
*Agent Name:
*Agent Email:
*Real Estate Firm:
*Agent Address:
*City:
*State:
*Zip:
*Agent Phone:
Agent Mobile:
*Agent Fax:

Seller Information
*Seller Name:
*Property Address:
*City:
*State:
*Zip:
*Seller Phone 1:
Seller Phone 2:
Age of Structure:
*Occupied?	Yes No
*Lock Box?	Yes No
*Termite Warranty Status:	Allgood Other None
*Type of Letter?	Pre-Listing Closing

If Closing is checked above, provide the following:

Purchaser Information
*Purchaser Name:
Purchaser Phone:

Attorney Information
Attorney Name:
Attorney Address:
City:
State:
Zip:
Attorney Phone:

Loan Information
*Type of Loan:	Conventional FHA VA Cash/Other
*Closing Date:

Other Information
*How would you like to receive your inspection report?	Pick up from our office Mail Leave Other
*If mail, leave or other, please explain?
Any additional information?

» Payments for services rendered at this service address will be due within 30 days of completion or at closing (whichever comes first). » Please allow 1 business day for a representative in your area to contact you.