Form 26-1805-1 REQUEST FOR DETERMINATION OF REASONABLE VALUE (Real Esta

Respondent Burden: 6 Minutes

SECTION 5: REQUESTER INFORMATION

SECTION 1: PROPERTY ADDRESS AND DESCRIPTION
APN / LOT Number:

Latitude / Longitude Grid:

Building Type:

Business / Lender Name

Requester Name

Requester Title

v
Property Address Line One:

Property Leasehold:

Requester Phone Number (Include area code)

Requester E-mail Address

Property Address Line Two:
Yes

Property Address City:

No

Verified by USPS?

Property Address State:
Property Address County:

Yes

No

Property Address Zip Code:

Business / Lender Address Line Two:
Business / Lender Address City:
Business / Lender Address State:

SECTION 2: LOAN TYPE AND INFORMATION
Appraisal Type

Business / Lender Address Line One:

Loan Use (If applicable)

Business / Lender Zip Code:

Building Status

Purchase

Renovation (Alternations/Repairs)

Proposed

Refinance

Construction

New Construction/Under Construction

Liquidation

Energy Efficiency Mortgage (EEM)

Liquidation

Other

Other

Other

Institution Case Number:

Lender

Yes

NEW OR PROPOSED CONSTRUCTION – COMPLETE BUILDER INFORMATION BELOW
Builder ID Number

Builder Phone Number (Include
area code)

SECTION 3: SPECIAL INSTRUCTIONS AND ADDITIONAL INFORMATION
Special Instructions

Other special instructions or invoice
information (Please describe)

Veteran/Seller Works Nights

Servicer

Can Assisted Appraisal Processing Program (AAPP) be utilized on this appraisal assignment?

Sales Price

Builder Name

Sponsor ID

Sponsor Type

Number of pages
in uploaded sales
contract

Pets on Premises

No

SECTION 6: VETERAN / BORROWER INFORMATION
Veteran Name

Other Borrower Name(s) (spouse, partner, etc.)

Veteran Address Line One:
Veteran Address Line Two:
Veteran Address City:
Veteran Address State:

House Alarm

Veteran Address Zip Code:

Gated Community
Special Energy Efficiency

Veteran Phone Number (include area code)

NOTE: INITIATING THE TIDEWATER PROCESS (VALUE NOT SUPPORTED)
When Purchase Price is not supported, Tidewater is to be sent to Tidewater POC in section 4.

SECTION 4: POINT(S) OF CONTACT INFORMATION
(PLEASE COMPLETE FOR PROPERTY ACCESS OR NOTIFICATION PURPOSES)
Lender Point of Contact Information
Lender POC Name

Lender POC Phone
Number (Include
area code)

Lender POC Email Address

Veteran E-mail Address

CERTIFICATION FOR SUBMISSION TO VA
On receipt of “Notice of Value” or upon advice from the Department of Veterans Affairs that a “Notice of Value” will not be
issued, we agree to forward to the appraiser the approved fee which we are holding for this purpose.

Veteran/Borrower Point of Contact Information
Veteran/Borrower POC Name

Signature of Person Authorizing this Request

Veteran/Borrower
POC Phone Number
(Include area code)

Person Authorizing Request Title

Veteran/Borrower
POC E-mail Address

Appraisal Request Date

Acceptance of Responsibility
Buyer Agent Point of Contact Information

Seller Agent POC Name

Buyer Agent POC Name

Buyer Agent POC
Phone Number
(Include area code)

Seller Agent Point of Contact Information

Buyer Agent POC
E-mail Address

Seller / Homeowner Point of Contact

Seller Agent POC
Phone Number
(Include area code)

Seller Agent POC Email Address

Builder Sales Office Point of Contact Information

Seller / Homeowner POC Name

Builder Sales Office POC Name

Seller / Homeowner
POC Phone Number
(Include area code)

Builder Sales Office
POC Phone Number
(Include area code)

Seller /
Homeowner POC
E-mail Address

By selecting the CHECKBOX above, you are certifying that you are requesting an appraisal by the VA appraiser to be
assigned automatically by LGY and you are aware that you are responsible for any charges incurred up to the full amount of
the approved appraisal fee as a result of the assignment. The assigned appraiser will automatically receive an e-mail
notification of the assignment and may begin to process this appraisal assignment. Please provide any supporting
documentation to the appraiser as soon as possible. A copy of this e-mail will be sent to the address you entered on the
assignment screen for your records. If a conflict exists with the assigned appraiser, please notify the Regional Loan Center of
jurisdiction immediately.

Builder Sales Office
POC E-mail Address

Tidewater Point of Contact Information
Tidewater POC Name

Tidewater POC Phone
Number (Include area code)

Tidewater POC E-mail
Address

OMB Control Number: 2900-0045; Form 26-1805; Respondent Burden 6 Minutes; Expiration Date 10/31/2023