Foundation Certification Order Form

LENDER/ORIGINATOR INFORMATION
Person ordering certificate:
Lender Realtor Owner Other
Company:
Company address:
City:
State / Zip:	/
Contact Phone:
Email to deliver report:

ORDER INFORMATION

Projected Closing Date:

Street Address of home:

City:

State / Zip:

County:

Contact person to gain access:

Name:

Owner Realtor Other

Phone:

Name to go on certificate (if different from contact person)

HUD label photo/verification requested: Yes No

Comments/Requirements other than normal cert inspection

Loan Information (check all that apply)

CHARGES AND PAYMENT INFORMATION
Check one (one must be checked to initiate order) Additional milage charges may apply
	$400.00 BORROWER IS TO PAY FOR ENGINEERING CERTIFICATION AT TIME OF INSPECTION. Lender has no responsibility for collection and has no liability to HLII for payment. Borrower understands that payment will be made via check, credit card or cash at the begining of the inspection.
	$450.00 PAYMENT WILL BE TAKEN OUT OF CLOSING. LENDER GUARANTEES PAYMENT IN THE CASE THAT THE LOAN DOES NOT CLOSE AND WILL PAY WITHIN 45 DAYS OF THE CERTIFICATION.
	$550.00 LENDER DOES NOT GUARANTEE PAYMENT AND BORROWER WISHES TO PAY FOR THE CERTIFICATION AT THE TIME OF CLOSING. Payment will be made at closing. Lender will submit invoice for HUD-1 statement. Lender has no responsibility for collection of payment if loan does not close. Borrower is responsible for payment should loan fail to close.Valid credit card must be submited to guarantee payment
POLICIES: • HLII must have inspections performed and photos taken by our certified inspector. Homeowner photos cannot be used. • HLII cannot “pre-approve” foundations without an onsite inspection. Form revised 3-19-09

Click on the above button to email to HLII or email lance@homelandinspectionsinc.com
or Call (360) 274-2900 with questions.