EVICTION FORM

Date: _________________________                                            Time: _______________________

Loan Number: __________________                                            Client: ______________________

Property Address: _________________________________________________________________

                   City: ___________________       State: ________________      Zip: _________________

Start Time: ___________          Stop Time: __________       Number Of Men: ______________

Personal Property:

Personal Property Removed:  __________(Cubic Yards)       Was Storage Required?   Yes ___ No ____

Describe: __________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

Debris:

Interior Debris Removed:  _______(Cubic Yards) Hazardous Debris Removed  _______(Cubic Yards)

Exterior Debris Removed: ________(Cubic Yards)

Describe: __________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

Property Preservation Completed:

Boarding:     Yes ____ No ____    No. of Windows ____      Estimate To Follow _________ 

Grass Cut:  Yes ____ No ___ Grass Maintained by Associate:Yes ___ No ___ Estimate To Follow ____

Swimming Pool / Jacuzzi:  Yes ____ No ___       In Ground ______     Above Ground ______

Secured:    Yes ____ No ___     Estimate To Follow  ________

Screen Enclosure / Fence:   Yes ____ No ___     Padlock On Gate:   Yes ____ No ___  

Winterization:   Yes ____ No ___  Dry Heat ___ Wet Heat ___ Partial ____ N/A _____

Common Water:  Yes ____ No ___  Sump Pump Present  Yes ____ No ___ 

Locks Changed  Yes ____ No ___Key Code: __________Animal Control Needed:  Yes ____ No ___ 

Additional Damages, Comments: _______________________________________________________

___________________________________________________________________________________

Is the Property in FHA Conveyance Condition?  Yes ____ No ___ 

Comments: _______________________________________________________________________

The above mentioned work has been completed at the time of the eviction and under the instructions/ supervision of the Law Enforcement Officer listed below:

___________________________        _______________________    ___________________

Officer's Name                                        Signature                                    Date