Cook's Termite and Pest Control, Inc. Inspection fax form

	Termite Inspection Order Cook's Termite & Pest Control, Inc. Fax: (614)263-0364
FROM:

Service(s) needed:

Termite Inspection____

Gas-Line Inspection____

Gas-Line Warranty____

Property Address:

Street:

Zip Code:

City:

County:

Seller:

Name:

Phone:

Buyer:

Name:

Phone:

Current Address:

How do we get in?

Deliver Report To:

(Include full name and address if delivery to a third party.)

Payment:
(Please check one)

______At time of Service

______At closing or within 30 days of service

Title Company:
Name: ____________________________________Phone:___________________

Closing Agent:______________________________Closing Date:______________

Billing information if property does not close:

Name:

Street Address:

City:

State:

Zip Code:

Additional information: