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Buyer Name: __________________________________________________________________________

Buyer Address:________________________________________________________________________

                         ________________________________________________________________________

Buyer Phone # ______________________________     Cell # ________________________________

Real Estate Agent:____________________________________________________________________

Real Estate Agency: __________________________________________________________________

Real Estate Phone # __________________________________________________________________

Listing Real Estate Agency: __________________________________________________________

Listing Real Estate Agency Phone #: ________________________________________________

MLS #________________________________ Location of Key _______________________________

Property Address: ____________________________________________________________________

                               ____________________________________________________________________

Utilities On?_______________ Type of Heat _____________________________________________

Propane or Natural Gas turned on? __________________Water On? ____________________

Date of Inspection: ____________________________Time:  _______________________________

Will Buyer be Present? ___________________ Will Seller be Present? ___________________

Square Footage: ______________Aprox. Age ____________Price Quoted_________________

Type of Inspection:___________________________________________________________________