Termite Inspection Request

Date Ordered Time Inspection Date
Inspector License #
Time In Time Out
Bill/Fax to Escrow Bill to Realtor
Realty Company Phone
Ordered By Fax
Seller/Owner (full name) Phone
Buyer (full name) Phone
Complete Jobsite Address
Vacant Lock Box #
Previously Fumigated Date
Company Warranty: (# years)
Ground Treated Warranty (# years)
Company Sentricon: (date)
Complete All Information
Escrow Company Closing Date Phone
Mailing Address Fax
City/State Zip
Escrow Officer Escrow #
Lender Phone Fax
Mailing Address
Loan Officer Financing
Type Condo House Townhouse Commercial Bedrooms
Reason Selling Refinancing Relocating
Schedule Appt. With Phone
* NOTE: INSPECTION VALID FOR 15 DAYS FROM DATE OF INSPECTION
   
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