Company

Lastname Address City

State

AK-Alaska AL-Alabama AS-American Samoa AZ-Arizona AR-Arkansas CA-California CO-Colorado CT-Connecticut DE-Delaware DC-District of Columbia FM-Federated States of Micronesia FL-Florida GA-Georgia GU-Guam HI-Hawaii ID-Idaho IL-Illinois IN-Indiana IA-Iowa KS-Kansas KY-Kentucky LA-Louisiana ME-Maine MH-Marshall Islands MD-Maryland MA-Massachusetts MI-Michigan MN-Minnesota MS-Mississippi MO-Missouri MT-Montana NE-Nebraska NV-Nevada NH-New Hampshire NJ-New Jersey NM-New Mexico NY-New York NC-North Carolina ND-North Dakota MP-Northern Mariana Islands OH-Ohio OK-Oklahoma OR-Oregon PW-Palau PA-Pennsylvania PR-Puerto Rico RI-Rhode Island SC-South Carolina SD-South Dakota TN-Tennessee TX-Texas UT-Utah VT-Vermont VI-Virgin Islands VA-Virginia WA-Washington WV-West Virginia WI-Wisconsin WY-Wyoming AE-Armed Forces Africa AA-Armed Forces Americas (except Canada) AE-Armed Forces Canada AE-Armed Forces Europe AE-Armed Forces Middle East AP-Armed Forces Pacific

Zipcode Phone Fax Email Website

(enter full web address including "http://")

State

AK-Alaska AL-Alabama AS-American Samoa AZ-Arizona AR-Arkansas CA-California CO-Colorado CT-Connecticut DE-Delaware DC-District of Columbia FM-Federated States of Micronesia FL-Florida GA-Georgia GU-Guam HI-Hawaii ID-Idaho IL-Illinois IN-Indiana IA-Iowa KS-Kansas KY-Kentucky LA-Louisiana ME-Maine MH-Marshall Islands MD-Maryland MA-Massachusetts MI-Michigan MN-Minnesota MS-Mississippi MO-Missouri MT-Montana NE-Nebraska NV-Nevada NH-New Hampshire NJ-New Jersey NM-New Mexico NY-New York NC-North Carolina ND-North Dakota MP-Northern Mariana Islands OH-Ohio OK-Oklahoma OR-Oregon PW-Palau PA-Pennsylvania PR-Puerto Rico RI-Rhode Island SC-South Carolina SD-South Dakota TN-Tennessee TX-Texas UT-Utah VT-Vermont VI-Virgin Islands VA-Virginia WA-Washington WV-West Virginia WI-Wisconsin WY-Wyoming AE-Armed Forces Africa AA-Armed Forces Americas (except Canada) AE-Armed Forces Canada AE-Armed Forces Europe AE-Armed Forces Middle East AP-Armed Forces Pacific

License #

Type

Residential Commercial

Expiration

Single Fam.

Condominium

2-4 Units

FHA

Rev. Mort.

Hi-End Res.

Vacant Land

Rent Survey

Oper. Inc. Stat.

Desk Review

Field Review