AMERICAN INSPECTION AGENCY, INC.
610-678-4336 · 1-800-806-6610 · Fax  610-678-4359
Online Home Inspection Request Form  Copyright© 2004-2014

Property Information (Site To Be Inspected):   

Street Address
Street Address 2    (Apt #, Suite #, Etc.)
City, State, Zip+4 +
County
Township/Boro
Single Family Dwelling Multi Family Dwelling
City Water And Sewer Hook-Up Yes    No
Is Property Presently Vacant Yes    No
Names Of Occupants   Tel. --
Exterior Description Of Home   Example: Brick, Siding, etc.
Approximate Age Of Home Years
Who Is Listing Realtor Or Seller?   Tel. --
Selling Realtors Name   Tel. --
Is Lock Box Present Yes    No
Date Needed

Buyers Information (People To Purchase Property):

Inspection Requested By   (Buyer's Name)
Buyer's Address 1
Buyer's Address 2   (Apt #, Suite #, Etc.)
Buyer's City, State, Zip+4 +
Buyer's County
Buyer's Township/Boro
Is This The Address For
Mailing Our Report? 		 Yes    No
Home Telephone --  Example:    555-123-4567
Work Telephone --  
Cellular Telephone --  
Representative For Buyer   Tel. --
Is Key To Be Picked Up? Yes    No         Where?

Inspection Services Requested:

  Basic Home          Well Test  
  Radon Test Kit     Septic Visual  
  Termite Visual   Re-Inspection  

*Note:  All Inspection Fees Are Due At The Time Of Inspection

DIRECTIONS AND ADDITIONAL INFORMATION:

   

Please complete and click submit. Directions are VERY important. We will call if more info is needed.