Self-Reporting Assessment Form Please complete this form if you received a pink tag at your property, stating that an appraiser was at your property. Appraiser that visited your property:(Required) Bonnie - 320-634-7720 Amy - 320-634-7721 Dylan - 320-634-7719 Name(Required) First Last PID #(Required)On pink slip or tax statement. Listed as PRCL# on tax statement. Example: 00-0000-000Phone(Required)Best time to reach you?In the event we have any questions on the information submitted.Type of HouseStick BuiltPole TypeSingle WideDouble WideModularYear built of house, if knownHouse addition years, and square foot of addition, if knownHouse InteriorPlease indicate how many of the following you have per level. For flooring types, indicate how many rooms per level have that type of flooring, if applicable. Living Room Basement/Lower LevelPlease enter a number from 0 to 10.First Story/Main LevelPlease enter a number from 0 to 10.Above Main/Upper LevelPlease enter a number from 0 to 10. Kitchen Basement/Lower LevelPlease enter a number from 0 to 10.First Story/Main LevelPlease enter a number from 0 to 10.Above Main/Upper LevelPlease enter a number from 0 to 10. Bedrooms Basement/Lower LevelPlease enter a number from 0 to 10.First Story/Main LevelPlease enter a number from 0 to 10.Above Main/Upper LevelPlease enter a number from 0 to 10. Full or 3/4 Bathrooms Basement/Lower LevelPlease enter a number from 0 to 10.First Story/Main LevelPlease enter a number from 0 to 10.Above Main/Upper LevelPlease enter a number from 0 to 10. Half Bathrooms Basement/Lower LevelPlease enter a number from 0 to 10.First Story/Main LevelPlease enter a number from 0 to 10.Above Main/Upper LevelPlease enter a number from 0 to 10. Laundry Area Basement/Lower LevelPlease enter a number from 0 to 10.First Story/Main LevelPlease enter a number from 0 to 10.Above Main/Upper LevelPlease enter a number from 0 to 10. Fireplace Basement/Lower LevelPlease enter a number from 0 to 10.First Story/Main LevelPlease enter a number from 0 to 10.Above Main/Upper LevelPlease enter a number from 0 to 10. Laminate/Vinyl Plank Floor Basement/Lower LevelPlease enter a number from 0 to 10.First Story/Main LevelPlease enter a number from 0 to 10.Above Main/Upper LevelPlease enter a number from 0 to 10. Tile Floor Basement/Lower LevelPlease enter a number from 0 to 10.First Story/Main LevelPlease enter a number from 0 to 10.Above Main/Upper LevelPlease enter a number from 0 to 10. Hardwood Floor Basement/Lower LevelPlease enter a number from 0 to 10.First Story/Main LevelPlease enter a number from 0 to 10.Above Main/Upper LevelPlease enter a number from 0 to 10. Carpet/Linoleum Basement/Lower LevelPlease enter a number from 0 to 10.First Story/Main LevelPlease enter a number from 0 to 10.Above Main/Upper LevelPlease enter a number from 0 to 10.Miscellaneous FeaturesSelect all that apply Quartz/Granite/Butcher Block/Tile Countertops Kitchen/Bathroom Tile Backsplash Vaulted Ceiling (one room or multiple rooms) Recessed Light (one room or multiple rooms) Wood Wall/Ceiling Finishing Solid Panel Doors Stained Concrete Floor Interior Fireplace Surround Tile Shower Surround Walk In Closet(s) Heat TypeSelect all that apply Forced Air Electric Baseboard GEO Thermal Floor/Wall Furnace Hot Water Gravity Heat Pump In-Floor Heat Space Heater No Heat Mini Split Other OtherHeat FuelSelect all that apply Natural Gas Propane Fuel Oil Electric Wood Other OtherElectrical Breaker box Fuse box Knob/tube Other OtherElectrical Amperage 50 Amp 100 Amp 200 Amp 250 Amp Other OtherPlumbing Original Partially Replaced Totally Replaced Basement FinishSelect all that apply Electric Wall Heat In-Floor Heat Under 8' Ceiling Height 8' Ceiling Over 8' Ceiling Height Wood Ceiling False/Grid Ceiling Drywall Ceiling Few Walls/Rooms Several Walls/Rooms Entire Basement Open (No Walls) Drywall Walls Panel Walls Wood Walls Stained Concrete Floor No Floor Covering Dry Bar Wet Bar Theater Room Wine Cellar Sauna Crawl Space less than 6' Basement Finish Amount 0% 25% 50% 75% 100% House Updates or RemodelPlease enter approximate year of update or remodelFoundationSidingRoofHeatingA/CWindowsBathroomInsulation/SheetrockFloor CoveringsElectrical SystemPlumbing SystemTotal Kitchen RemodelKitchen Cabinets Remodeled/PaintedCounter Top ReplacementGarage InformationGarage Stick Built Pole Type Year built of garage, if knownGarage Interior FinishSelect all that apply Insulated Sheetrock Lined Wood/Tongue & Groove Lined Steel/Metal Lined Forced Air/Space Heater In-Floor Heat No Concrete Floor No Electricity A/C Basement Access Epoxy/Tile Floor Kitchen Mezzanine Floor Drain(s) Plumbing/Bathroom Bonus Room Above Garage Garage Updates or RemodelPlease enter approximate year of update or remodel)SidingWindows/DoorsRoofHeat/ACInterior Finish Please contact your appraiser at their direct line above with any information that may help them correctly value your property. Thank you! CAPTCHA
