All Sure Home Inspections

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Inspection Agreement Form

Client Information

*Required Information All information will be kept confidential.

Client Information:

Title:

*First Name:

*Last Name:

*Street Address:

*City:

*Zip Code:

*Phone:

Fax:

*E-mail:

Location to be Inspected:

*Street Address:

*City:

*Zip Code:

*County:

Nearest Cross Street:

Preferred Inspection Date:

Preferred Inspection Time:

Client's Attorney Information:

Attorney Name:

Attorney Email:

Attorney Phone:

Attorney Fax:

Client's Realtor Information:

Real Estate Agency:

Realtor Name:

Realtor Phone:

Realtor Fax:

Realtor E-Mail:

Cost Estimate

Single Family Home:

Townhouse:

Condominium:

Radon Testing:

Referral Termite Inspection:

Senior Citizen, Fire, Police Discount 10% (must be buyer)

On the day of the inspection, please make a check payable to: All Sure Home Inspections, LLC

You will need an additional check for the pest control company if we schedule the termite inspection
for the same time.

Accept Agreement Will Fax Agreement Decline Agreement