Home Inspection Request Order Form | Rick Daniel Home Inspections

PURPOSE OF THIS FORM

This form provides a means to collect the data needed to schedule a Home Inspection Appointment, send out the "official" Home Inspection Agreement, prepare the report template and connect with the client to discuss how we can best serve their needs.

Today's Date *

Your Name

Your Email Address

BUYER'S INFORMATION

Buyer's Name

Buyer's Street Address

Buyer's CITY, STATE, ZIP

Buyer's Phone Number

Buyer's Email Address

Buyer's Realtor/Agent Information

Buyer's Realtor/Agent Name

Agent's Company

Agency Street Address

Agency CITY, STATE, ZIP

Buyer's Agent Phone Number

Buyer's Agent Email Address

OWNER'S INFORMATION

Owner's Name

Owner's Street Address

Owner's CITY, STATE, ZIP

Owner's Phone Number

Owner's Email Address

Owner's Realtor/Agent Information

Owner's Realtor/Agent Name

Agent's Company

Agency Street Address

Agency CITY, STATE, ZIP

Owner's Agent Phone Number

Owner's Agent Email Address

INSPECTED PROPERTY DETAILS

Inspected Property Street Address *REQUIRED FIELD* *

Inspected Property CITY, STATE, ZIP *REQUIRED FIELD*

Year Built

Square Footage

The Premium Inspection fee is based on the square footage. See "Price List" for fee.

Select Inspection Type

Premium Inspection. Full Descriptive Detail. Cash Discount Available. Fees Based on Sq. Ft.

Occupancy Status

Occupied full time

Vacant. No furniture

Furnished, occupied part time

Utilities Status. Check all that apply.

Garage Status? Check all that apply. (Depending on size, an additional $55-$75 fee is added for each detached garage)

None

Attached

Detached

Attached and detached garages are both present.

Attached Definition: You can walk directly from the inside of the living space into the garage.
Detached Definition: You have to fully exit the living space to access the garage.

Detached Building Status? (Depending on size, an additional $55-$75 fee is added for each detached "non-living space" building)

None

Detached Barn

Detached Shop

Other (please describe in "Special Instructions" below).

Describe "Other" if noted above.

Additional Living Spaces? (Multiple Dwellings, Multiple Tenants) Check all that apply. Additional "Custom" fees apply.

None

Multiple living quarters in the same building (ie: duplex, triplex, apartments)

Multiple buildings with separate living quarters (ie. Mother-In-Law cottage, etc).

Describe Multiple Living or Multiple Buildings if noted above.

BILLING AND ACCESS DETAILS

Method of Payment

To Be Determined by Inspector

Paid Direct By Check

Paid Direct By Cash ($50 discount off the base fee)

Paid by Credit or Debit Card

Paid Direct By "Zelle"

To Be Paid Through Escrow (an additional signature document will be sent confirming this request)

This order form is not an Inspection Agreement and does not hold the client's representative responsible for any financial obligation. The client is solely responsible for payment of this service. The actual Inspection Agreement will be sent after discussing the process with the client.

TITLE COMPANY

Title Company Escrow Officer

Title Company FULL Address, CITY, STATE, ZIP

Title Company Phone Number

Escrow Officer's Email Address

Escrow Number

Escrow Closing Date

How Will I Gain Access To The Property? *REQUIRED FIELD* *

Who Will Be Present?

Include Special Instructions and Inspection Date Requests Here

RESIDENTIAL INSPECTION AGREEMENT NOTICE

Revision: January 23, 2025
This form document NO LONGER represents an agreement to conduct work for the client.

This form provides a means to collect the data needed to schedule a Home Inspection Appointment, send out the "official" Home Inspection Agreement, prepare the report template and connect with the client to discuss how we can best serve their needs.

Click the button below to submit your order request, then call (209) 768-2142 to set an appointment.

Thank you

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