CLIENT NAME (The person who is paying for the inspection)

STREET ADDRESS (the property to be inspected)

CITY                                                                      STATE     ZIP CODE

PHONE W/AREA CODE         CELL W/AREA CODE            FAX W/AREA CODE
             
EMAIL ADDRESS                                                     SEND RESULTS TO
    My Email Address My Fax Number The Address Below
MAILING ADDRESS (If different from above - Leave blank if same or if you selected email or fax)

Note: AMI does not not release reports to anyone other than you, our client. We do not give copies to anyone. Report copies to any interested parties can only be obtained from you.

TYPE OF PROPERTY                                              SQUARE FOOTAGE
Residential Single Family Home / 1 Story Residential Single Family Home / 2 Stories Residential Single Family Home / 3 Stories Residential Single Family Home / 4 Stories Residential Condominium / 1 Story Residential Condominium / 2 Story Residential Apartment / 1st Floor Residential Apartment / 2nd Floor Residential Apartment / 3rd Floor Residential Apartment / 4th Floor Commercial Storefront Commercial Business Office Commercial Shop Commerical Manufacturing   
FOUNDATION TYPE             APPROXIMATE AGE         ROOF TYPE
Concrete Slab Raised Foundation Stilts Basement Not Sure      
PLEASE SELECT ONE OF THE FOLLOWING
Owner Occupied Tenant Occupied / I am the Owner Tenant Occupied / I am the Tenant Tenant Occupied / I am the Agent Real Estate Transaction / I am the Buyer Real Estate Transaction / I am the Buyers Agent Real Estate Transaction / I am the Seller Real Estate Transaction / I am the Sellers Agent Real Estate Transaction / I am the Agent Exclusive Real Estate Transaction / I am the Lender Real Estate Transaction / I am the Insurer Client Property / I am the Contractor Client Property / I am the Lender Client Property / I am the Insurer Post-Remediation Clearence Test
IS THE PROPERTY IN A GATED COMMUNITY? 
Yes No     ENTRY CODE 
IS THERE A LOCK BOX? 
Yes No   COMBINATION 
PREFERRED DATE AT TIME OF APPOINTMENT

NOTES

NAME:

EMAIL OR PHONE WITH AREA CODE:

HOW CAN WE HELP YOU?