Foundation Certification / Install Form

AAA Contracting serves the I5- Hwy 97 Corridor in Oregon from north border to south border. If you are outside of our normal area, we can still help you – but we will need to charge for mileage beyond our normal service area. Please call us at  541-504-0799 if you are in outlying areas and would like a mileage estimate. 

ABOUT YOU

Name of Person filling out form

BORROWER OR SELLER INFORMATION

Borrower/Seller Name *

First

Last

Borrower/Seller Address

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Borrower/Seller City

State

Zip Code

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Home Phone

Cell Phone

Email *

REALTOR INFORMATION

Buyer's Agent:

Realtor Name

First

Last

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Phone

Email *

Seller's Agent:

Name

First

Last

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Phone

Email *

LENDER/ORIGINATOR INFORMATION

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Company Name:

Contact:

Email *

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Address

Address Line 1

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Phone

Loan Information: *

• FHA
• VA
• USDA
• Reverse
• Conventional, conforming (Fannie Mae/Freddie Mac)
• Conventional, non-conforming

HOME INFO

Home Type: *

• Manufactured
• Site Built Home
• Modular Home

Manufactured Home Size:

• Single Wide
• Double Wide
• Triple Wide

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Property Address to be inspected: *

Address Line 1

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Is the home... *

• Vacant
• Occupied

Tie Down Installation ** (call for pricing, (541) 504-0799 or email aaacon@aaahomeinspection.org)

• Tie Down Installation ** (call for pricing, (541) 504-0799 or email aaacon@aaahomeinspection.org)

Other Work Requested

PAYMENT

Manufactured Home Fee Options (choose one)

• $425 - Certification paid at inspection
• $450 – Certification Paid by Credit Card
• $475 - Certification lender guaranteed billed to escrow

Site Built/Modular Home Fee Options (choose one)

• $475 - Certification paid at inspection
• $500 – Certification Paid by Credit Card
• $550 - Certification lender guaranteed billed to escrow

Will the invoice be paid out of escrow? *

• Yes
• No

**If yes, lender guarantees payment. Please complete escrow information. Payment will be secured with credit card:

ESCROW INFORMATION

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Escrow Company:

Escrow Contact:

Escrow #:

Escrow Co. Phone:

Escrow Close Date:

Escrow Co. Email:

MISC. INFORMATION/SPECIAL INSTRUCTIONS:

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