REALTOR INSPECTION REQUEST FORM

Realtor Name and Agency
Customer Name
Customer Address
City, State, Zip
Phone Number
Email Address
Payment Responsibility
MLS #
Seller's Name
Address of Property to be Inspected
Inspections Needed :

Structural (whole house)
Water (bacteria only)
Wood Destroying Insect
Radon
Water FHA
Water VA
Septic Pumping*
*If you desire pumping done as part of inspection check "Pumping" above. Note that additional fees apply.
Listing Agent & Agency
Is the property to be inspected currently Vacant? Yes No
Buyer to be at Inspection Yes No

Seller to be at Inspection

Yes No
Preferred Dates and Times of Inspection Date Time
  Date Time
Comments