Appraiser Application

* Indicates a required field (Please enter either a FedTaxId or SSN, not both)

General Information
*Name:
*Company:
*Email Address:
ALL VENDORS MUST BE ABLE TO RECEIVE ALL ASSIGNMENTS AND STATUS UPDATES VIA EMAIL.
Physical/Fed Ex Address
Street Address:	City:
State:	Zipcode:
Mailing Address
Street Address:	City:
State:	Zipcode:
Telephone Numbers
*Office:	- -
Home:	- -
Pager:	- -
Cell:	- -
Fax:	- -
Other:	- -
Qualifications
*Are you incorporated?	Yes   No
*Are you licensed?	Yes   No
*Are you certified?	Yes   No
*Are you a HUD-approved appraiser?	Yes   No
*Fed Tax ID:
*SSN:
License/Certification No.:
Expiration: (MM/DD/YY):
Type of License:
*Have you ever had any Real Estate License suspended, restricted or revoked OR have you ever been convicted of a felony or any public offense having as one of its elements a fraudulent or dishonest act?
Yes No
If yes, please furnish details:
*Are you currently carrying Errors & Omissions insurance on your work?
Yes No
If yes, with which Company:
Policy Limit:
Policy No.:
Expiration (MM/DD/YY):
Appraisal Activity Areas
List all counties where you feel qualified to complete appraisal assignments.
Please note any city exclusions and list the zipcodes if applicable:
*Is there any section of your service area that does not have access to MLS?
Yes No
If so, what areas?
Prior Employment
Beginning with your present position, list all employment related to appraising in reverse chronological order for the last 5 years.
Employer 1
Month/Year From (MM/YY):
Month/Year To (MM/YY):
Name and Address of Employer:
% of Time Devoted to Appraising:
Employer 2
Month/Year From (MM/YY):
Month/Year (MM/YY) To:
Name and Address of Employer
% of Time Devoted to Appraising:
Employer 3
Month/Year From (MM/YY):
Month/Year To (MM/YY):
Name and Address of Employer
% of Time Devoted to Appraising:
Employer 4
Month/Year From (MM/YY):
Month/Year To (MM/YY):
Name and Address of Employer
% of Time Devoted to Appraising:
Employer 5
Month/Year From (MM/YY):
Month/Year To (MM/YY):
Name and Address of Employer
% of Time Devoted to Appraising:
References
List three verifiable clients and/or employers (must be either mortgage lenders, private mortgage insurers, secondary mortgage purchasers, or government agencies) which have accepted your appraisal reports, and may be contacted by Urban Settlement Services, Inc.. Please make certain that your reference information is correct.
Reference 1
Company name and Address:
Contact/Title:
Type of Business
Phone Number:	- -
Reference 2
Company name and Address:
Contact/Title:
Type of Business
Phone Number:	- -
Reference 3
Company Name and Address:
Contact/Title:
Type of Business
Phone Number	- -
Software
What type of appraisal software are you using?
A La Mode - WinTotal Bradford Technologies - Appraiser's Toolbox Day One - Nova Day One - AppraisalWorks United Systems - HighPerForm Polaroid Digital Solutions - ACI Collection Other
If other, please describe
Maximum Daily Orders
* Maximum daily orders you can accept from us:
Fee Schedule
Single Family Residential: (Please list fees for a 1004 form and the 2055 form). This appraisal is for a second mortgage or equity Line, it meets FNMA requirements & FIRREA regulations. However, along with the 1004/2055 we only require an exterior perimeter sketch and a location map. We don't require deed copies or plat maps. Any addenda are kept to a minium (whatever is an absolute necessity.
*1004/1073 Form:	$
*2055 Exterior Form:	$
*2055 Interior Form:	$
Reinspection or Final Inspection: Reinspection is used when there was a cost to cure on the original appraisal or when the appraisal was completed "subject to" and the lender wants to be sure that the work was completed. Final Inspection is used when the original appraisal was completed on a property that was under construction with the use of plans and specfications and is now complete and needs final inspection.
*Reinspection or Final Inspection:	$
Recertification: Recertifications are used if an appraisal was completed less than 6 months prior on the property and the homeowner wants additional funds. The appraiser will recertify the value.
*Recertification:	$
Final Inspection (Form 442)
*Form 442:	$
Field Review: (FNMA 2000) CSS uses field reviews primarily for quality control purposes. The appraiser will receive as much of the original appraisal as we have available.
*FNMA 2000:	$
*Multi Family: (1025 Form):	$
*FHA/HUD Appraisal URAR: (1004 Form)	$
Desktop: (FNMA 2006) The appraiser will receive as much of the original appraisal as available.
*FNMA 2006:	$
On occasion, we will ask for a report without requiring comp photos. If this situation occurs would your fee differ? If yes, list the amount to be deducted from each product type when comp photos are not required.
Amount Deducted:	$
Appraisal Education
Please send a list of professional and technical appraisal courses satisfactorily completed. Furnish names and addresses of schools attended, courses taken and dates of attendance. Also include all appraisal conferences, seminars and clinics attended. Please email to gsanders@urbansettlement.com or fax to (412) 586-1397.
Licensing & Insurance Information
Please send a copy of state appraisal license or certificate. Also attach a copy of the declaration page of your E & O insurance. Please email to gsanders@urbansettlement.com or fax to (412) 586-1397.
Statement
The foregoing application has been completed by me to induce Urban Settlement Services, Inc. to approve me as a Real Estate Property Appraiser. I hereby certify that the answers and statements given herein are true and correct to the best of my knowledge and belief. In connection with my application I understand that my references and/or pervious employers will be contacted.