Termite Inspection Request Form

REQUEST:

Requested by:

Date:

E-Mail:

Do want a copy of the e-mail generated by this form?

Yes / No

SELLER:

Name:

Primary Phone:

Other Phone:

Refinance?

Yes / No

(Payment required at time of service)

LISTING AGENT:

Company:

Name:

Fax:

Office Phone:

Mobile Phone:

Agents, please note: If escrow cancels for any reason, payment is due
immediately by the seller. Please make the seller aware of this fact.

BUYER:

Name:

Primary Phone:

Other Phone:

BUYER'S AGENT:

Company:

Name:

Fax:

Office Phone:

Mobile Phone:

PROPERTY:

Street Address:

City:

State:

Zip Code:

Gated Comm.

CBS Code:

Lock Box?:

Yes / No

Occupied?:

Yes / No

Paid at COE by:

Buyer / Seller

HOME INSPECTION:

Include inspection by our affiliate, Desert Suburban Properties?

Yes / No

Does the home have a pool and/or Spa?

Yes / No

Are water and electricity on?

Yes / No

Is the electric panel accessible?

Yes / No

Square Footage:

Year Built:

CONTRACT

Date Signed:

Close of Escrow:

Escrow Officer:

Escrow #:

10-day inspection period ends:

TITLE COMPANY

Company:

Street Address:

City:

State:

Zip Code:

Office Phone:

Fax:

Note: Fields with labels in gray italics are optional.