Clearance Letter / Wood Destroying Organism Report Request Form Agent #1 Name(Required) First Last Agency/Company(Required)Email(Required)Represent(Required) Buyer Seller Person Responsible for Payment(Required)Agent #2 Name(Required) First Last Agency/Company(Required)Email(Required)Represent(Required) Buyer Seller Property InformationAddress(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Currently Occupied?(Required) Yes No Lockbox Code(Required)Type of Structure(Required) Basement Finished Basement Unfinished Slab Crawl Space Unknown Additional StructuresAre there any additional structures besides the home itself needing inspection?(Required) Yes No Please identify each additional structure to be inspected. (Examples: Utility building, workshop, chicken coop, detached garage, guest house, storage shed, pond house, pole barn, etc.)Other InformationSeller Name(Required) First Last Seller Phone(Required)Seller's Email Address(Required)Buyer Name(Required) First Last Buyer Phone(Required)Buyer's Email Address(Required)Closing Attorney(Required)Requested Date(Required) MM slash DD slash YYYY Closing Date(Required) MM slash DD slash YYYY Email address where report needs to be sent(Required)Comments(Required)Loan TypeLoan Type(Required) Cash VA USDA FHA Conventional Other NameThis field is for validation purposes and should be left unchanged. Δ
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