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Construction Order Form

Date: ________________

Ordered by:__________________

Company:____________________

Phone:______________

Fax:________________

Builder:________________________Phone:___________________

Loan Officer:________________________Phone:___________________

Company:______________________Fax:_____________________

Owner:________________________SSN:_________________

Buyer:_________________________SSN:_________________

Property Address:

Street:________________________________________

City:__________________State:____ZIP____________

Tax ID Number:________________________

Sales Price:$____________________________

Construction Loan Amount:$______________________

Endorsements: 8.1 100 116 PUD 6.0 ARM (Please Circle)

Please fax a copy of the REPC or applicable purchase agreement with this order. Thank you!

Other Instructions:_______________________________

_______________________________________________

Please fill in all appropriate blanks and fax to the appropriate office.

Thank you very much for using our website and we will be in contact with you soon!

Logan Office Fax (435)752-3612 11 W Center, Logan, UT 84321	Garden City Office Fax (435)946-4012 115 S Bear Lake Blvd., Garden City, UT 84028
Preston Office Fax (208)852-9300 96 South State, Preston, ID 83263	Montpelier Office Fax (208)847-0881 680 N 4th Suite 1, Montpelier, ID 83254
Malad Office Fax (208)766-7702 215 East 50 South Suite #5, Malad, Id 83252	Afton Office Fax (307)885-3602 290 S Washington, Afton, WY 83110
Evanston Office Fax (307) 789-2017 849 Front Street Suite 103, Evanston, WY 82930	Kemmerer Office Fax (307)877-1206 727 Cedar Avenue, Kemmerer, WY 83101
Rock Springs Office Fax (307) 362-8833 1471 Dewar Drive #106, Rock Springs, WY 82901	Pinedale Office Fax (307)367-3742 110 North Jackson, Pinedale, WY 82941