Requestor’s Role in the Transaction
*
Please Select
Buyer
Seller
Realtor/Broker
Attorney
Lender
Property Manager
Other
Please indicate your role in relation to this property or transaction.
Please Specify Role
*
Requesting Party Contact Name
*
First Name
Last Name
Requesting Party Contact Email
*
example@example.com
Requesting Party Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Client / Company Name
*
This is who will be on the Phase I Agreement & Report
Client / Company Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Client / Company Contact Name
*
First Name
Last Name
Client / Company Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Client / Company Contact Email
*
example@example.com
Subject Property Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Property Type
*
Please Select
Retail
Office
Industrial
Warehouse
Multi-Family
Mixed-Use
Vacant Land
Other
What Was The Prior Use of The Vacant Land?
*
Parcel Identification Number(s) (PINs)
*
Enter all parcel identification numbers associated with the property. Separate multiple parcels with commas or line breaks.
What Type of Operation(s) is in the Industrial?
*
Number of Multi-Family Units?
*
Property Type - Other
Approximate Building Size (sq.ft.)
Approximate Site Size (acres)
*
Year Built (if known)
Current Property Use
*
Please Select
Residential
Commercial
Industrial
Vacant Land
Unknown
Proposed Property Use (if known)
Please Select
Residential
Commercial
Industrial
Vacant Land
No Change
Unknown
Previous Property Use (if known)
Please Select
Residential
Commercial
Industrial
Vacant Land
Unknown
Purpose of Assessment
*
Please Select
Real Estate Transaction
Refinancing
Due Diligence
Internal Risk Assessment
Other
Other
*
Is this for an SBA Loan?
*
Please Select
Yes
No
Closing Date or Deadline?
*
/
Month
/
Day
Year
Date
Are you aware of any environmental concerns at the property?
Please Select
No
Yes (please explain)
Environmental Concerns
Property Access Contact
Provide the contact information for the individual authorized to grant access to the property (e.g., owner, tenant, or property manager) if known.
Access Contact
First Name
Last Name
Access Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Access Contact Email Address
example@example.com
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