Termite Inspection Order Form

Required fields are marked with an asterisk (*)

Inspection Information

Inspector Requested:

*Requested Inspection
Completion Date: (Month / Day / Year)

*Payment Method:
Buyer thru escrow Seller thru escrow At time of service

*Ordered By (Your Name):

*Phone:

*Fax:

Email:

Property Information

*Street:

*City:	*State:	*Zip:

*Property is: Occupied Vacant

*Access Instructions:
On Lock-box: Yes No If yes, what is the code:

Additional Entry Instructions:

Seller Information

*Name:

*Phone:

Agent Name:

Agent Company Name:

Agent Phone:

Agent Fax:

Buyer Information

*Name:

*Phone:

Agent Name:

Agent Company Name:

Agent Phone:

Agent Fax:

Billing Information

*Title Company:

*Escrow Officer:

*Escrow Number:

*Escrow Close Date: (Month / Day / Year)

*Street:

*City:	*State:	*Zip:

*Phone:

*Fax:

Additional Information

Comments/Notes: