| Preferred Inspection Date (mm/dd/yyyy) |
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| Preferred Time (am/pm) |
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| Age of Home in Years |
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| Approximate Square Footage of Home |
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| Inspection Site Street Address |
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| Inspection Site City State Zip |
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| Customers Name |
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| Customers Address |
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| Customers City State and Zip |
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| Customers Home phone |
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| Customers Cell phone |
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| Customers Work phone |
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| Customers Email address * |
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| Agents Name |
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| Agents Company Name |
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| Agents Address |
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| Agents City State and Zip |
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| Agents Office phone |
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| Agents Cell phone |
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| Agents Email address |
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| Crawl Space? Yes or No |
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| Pool? Yes or No |
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| Spa? Yes or No |
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| Additional Buildings? Yes or No |
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| Detached Garage? Yes or No |
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| WDO Inspection? Yes or No |
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| Security System? Yes or No |
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| Is water still on? Yes or No |
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| Is Electric still on? Yes or No |
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| Who will be present? (Customer or Agent) |
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| Any additional comments or concerns? |
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A $50 travel fee will be charged if utilities are not turned on and inspector can not conduct inspection or if inspector must make a second trip to complete inspection |
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| I have reviewed and agreed to the Home Inspection Agreement * |
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