Vision Appraisal Services, Inc.

3434 W Anthem Way, #118-626

Anthem AZ  85086

623-551-2261 / 623-551-4377

www.visionappraisals.net

BILLING AUTHORIZATION FORM

By completing the information below you will be authorizing the billing and accepting responsibility for the appraisal payment.  Payment will be due upon receipt of the billing invoice and/or shall not exceed 5 days from the close of escrow of the subject property. 

Lender / Broker                                                                                     Loan Officer / Processor

Address                                                                                                 City                                                         Zip

                                                                                                            /                                  

Email                                                                                       Phone                                         Fax

Appraisal Request Date                                                        Borrower

Address of Appraisal                                                                               City                                                         Zip         

Title Company                                                                      Address

Signature                                                                                               Date

NOTE:  This billing authorization gives Vision Appraisal Services, Inc. specific rights to pursue other means of collection in the event of non-payment.  The Lender / Broker is ultimately responsibility for the appraisal payment and will be pursued in the event of non-payment.

Please contact the accounts receivable department at 623-551-2261 should you have questions regarding our accounting policies.  Thank you for your business.