Va Form 26-1805 - Request For Determination Of Reasonable Value (Real Estate)
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1
2OMB Control No. 2900-0045
Respondent Burden: 12 minutes
REQUEST FOR DETERMINATION OF REASONABLE VALUE (Real Estate)
1. CASE NUMBER
4. TITLE LIMITATIONS AND RESTRICTIVE
COVENANTS:
2. PROPERTY ADDRESS (Include ZIP Code and county)
3. LEGAL DESCRIPTION
PLANNED UNIT
1.
CONDOMINIUM
2.
DEVELOPMENT
5A. NAME AND ADDRESS OF FIRM OR PERSON MAKING REQUEST/APPLICATION (Include ZIP Code)
6. LOT DIMENSIONS:
1.
IRREGULAR:
SQ/FT
2.
ACRES:
7. UTILITIES ( X )
ELEC. GAS WATER SAN. SEWER
1. PUBLIC
2. COMMUNITY
3. INDIVIDUAL
8.
1.
RANGE/
4.
CLOTHES
7.
VENT
OVEN
WASHER
FAN
E
Q
8.
W/W
2.
REFRIG.
5.
DRYER
U
CARPET
5B. E-MAIL ADDRESS (TO BE NOTIFIED WHEN APPRAISAL UPLOADED)
I
DISH
GARBAGE
P.
3.
WASHER 6.
DISPOSAL
9. BUILDING STATUS
3.
EXISTING
10. BUILDING TYPE
11. FACTORY
12A. NO. OF
12B. NO. OF
13A. STREET
13B. STREET
FABRICATED?
BUILDINGS
LIVING UNITS
ACCESS
MAINTENANCE
3.
ROW
1.
DETACHED
ALTERATIONS,
1.
PROPOSED
1.
PRIVATE
1.
PRIVATE
APT.
SEMI-
IMPROVEMENTS,
UNIT
2.
NEW CONSTRUCT.
4.
2.
DETACHED
4.
1.
YES 2.
NO
OR REPAIRS
2.
PUBLIC
2.
PUBLIC
14A. CONSTRUCTION WARRANTY
14B. NAME OF WARRANTY PROGRAM
14C. EXPIRATION DATE
15. CONSTRUCTION COMPLETED
INCLUDED?
(Month, day, year)
(Month, year)
(If "Yes," complete
Items 14B and 14C also)
1.
YES
2.
NO
18. RENT (If applicable)
16. NAME OF OWNER
17. PROPERTY:
OCCUPIED BY
NEVER
OCCUPIED BY TENANT
OWNER
OCCUPIED
VACANT
(Complete Item 18 also)
$
/ MONTH
19. NAME OF OCCUPANT
20. TELEPHONE NO.
21. NAME OF BROKER
22. TELEPHONE NO.
(Include Area Code)
(Include Area Code)
23. KEYS AT (Address)
24. ORIGINATOR'S IDENT. NO. 25. SPONSOR'S IDENT. NO.
26. INSTITUTION'S CASE NO.
27. PURCHASER'S NAME AND ADDRESS (Complete mailing address, Include ZIP Code)
EQUAL OPPORTUNITY IN HOUSING
NOTE: Federal laws and regulations prohibit
discrimination because of race, color, religion, sex,
or national origin in the sale or rental of residential
property. Numerous State statutes and local
ordinances also prohibit such discrimination. In
addition, section 805 of the Civil Rights Act of 1968
prohibits discriminatory practices in connection with
the financing of housing.
If VA finds there is noncompliance with any
antidiscrimination laws or regulations, it may
discontinue business with the violator.
28. NEW OR PROPOSED CONSTRUCTION - Complete Items 28A through 28E for new or proposed construction cases only
A. NAME AND ADDRESS OF BUILDER
B. VA BUILDER ID NO.
C. TELEPHONE NO.
D. NAME AND ADDRESS OF WARRANTOR
E. TELEPHONE NO.
(Include Area Code)
(Include Area Code)
29. APPLICABLE POINT OF CONTACT (POC) INFORMATION
30. ANNUAL REAL ESTATE TAXES
32. LEASEHOLD CASES (Complete if applicable)
$
A. LEASE IS:
B. EXPIRES (Date)
31. MINERAL RIGHTS RESERVED?
99 YEARS
YES (Explain)
C. ANNUAL GROUND RENT
RENEWABLE
NO
$
33A. SALE PRICE OF PROPERTY
33B. IS BUYER PURCHASING LOT
34. REFINANCING-AMOUNT
35. PROPOSED SALE CONTRACT ATTACHED
SEPARATELY?
OF PROPOSED LOAN
YES
YES
(If "Yes," see instruction page under
"Sale Price")
NO
NO
$
$
CERTIFICATION FOR SUBMISSION TO VA
On receipt of "Notice of Value" or advice from the Department of Veterans Affairs that a "Notice of Value" will not be issued, we agree to forward to
the appraiser the approved fee which we are holding for this purpose.
36. SIGNATURE OF PERSON AUTHORIZING THIS REQUEST
37. TITLE
38. TELEPHONE NUMBER
39. DATE
(Include Area Code)
40. DATE OF ASSIGNMENT
41. NAME OF APPRAISER
WARNING: Section 1010 of title 18, U.S.C. provides: "Whoever for the purpose of . . .influencing such Administration . . .makes, passes, utters or publishes
any statement knowing the same to be false . . .shall be fined not more than $5,000 or imprisoned not more than two years or both."
VA FORM
26-1805
SUPERSEDES VA FORM 26-1805, AUG 2004,
AUG 2008
WHICH WILL NOT BE USED.
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