Appraiser Request Form

Any variation from these steps could result in a delay in reviewing the application. Please complete ALL of the following information:

Step One: Description (Only Select One)

New Applications or Inactive Appraisers (Resume, Showing their work history, Copy of their state license and they must be state licensed & FHA licensed or greater for a minimum of 5 years, Copy of E & O Policy, Copy of a completed W-9 Form)

Conditions (Missing documents or information from application package)

License Update (Only for appraisers currently approved with Envoy but have an expired license)

Other:

Step Two: Information

Appraiser's Name
Appraiser's Company
Appraiser's Phone Number
Appraiser's Fax Number
Appraiser's Address
Appraiser's City
Appraiser's State
Appraiser's Zip Code
Appraiser's E-mail

Step Three: Attachments (This information must accompany all new applications and each box must contain a document)

Resume with 5 most recent years appraising experience: Months and years to be listed

Copy of current license. Must have legible license number and expiration date for all states

Copy of E&O Insurance

States licensed with Counties & Zip Code coverage areas W-9 form, fully completed

W-9 form, fully completed

Step Four: Acknowledgement and Agreement

I agree by signing this request form that I certify all information listed above and attached to this document is true and correct as of the date set forth opposite my signature. I agree that any intentional or negligent misrepresentation of this information contained in this application may result in civil liability, including monetary damages, to any person who may suffer any loss due to reliance upon any misrepresentation that I have made on this application. I certify that I have not been placed on an industry exclusionary list or list of debarment. I acknowledge that Envoy Mortgage, LTD may verify or recertify any information contained on this request form, for legitimate business purpose through any source.


Appraiser's Signature	Date