Farm Kit/Labels Order Form

		An Industry Leader

Empire West can provide you with detailed information about farm properties in Maricopa county. Simply fill out the following form as completely as you can, and click the submit button at the bottom.

1. Your Information

Provide information about yourself. Please use current contact information so that we can get in touch with you, if necessary.

Contact Name:
Company Name:
Address:
City:
State:
ZIP:
Office Phone:
Cell Phone:
FAX:
E-mail Address:
Contact at Empire West:

2. Property Identification Method

There are many ways we can identify properties. Choose the method that best suits the information you have available.

1. Property
Owner Name:
Address:
City:
State:
ZIP:
Tax Parcel #:
Legal:
2. Boundaries
Details:
3. Parcel Range
From:
To:
4: City/ZIP Codes
Codes:

3. Report Options

Select the elements you would like to include in your report. Be sure to provide details when needed.


	Sales Price Range
	From:
	To:

	Transfer Date
	From:
	To:
	Parcel Maps
	Owner Occupied
	Absentee Owners
	Only Records w/Phones

4. Report/Label Format

Choose the report or label format you would like.

6 Line (Includes Lender Info)
1 Line Phone Farm
Disk	ASCII DBase Excel
Labels	Site Address
		Addressed To: Owner Current Resident And/Or Current Resident Other
	Mail Address
	Other

5. Delivery Method and Special Instructions

Choose a delivery method from the options below. Be sure that you have provided the correct information (phone number, address, etc.) in the first section of this form. If you have any special instructions regarding the delivery of your labels or report(s), type them in the box provided.

	FAX
	Courier (Where available. Note below in special instructions if address is a home address)
	Sales Rep to Deliver
	U.S. Mail
	E-mail (when applicable)
	Other

Special Instructions

6. Submit You Request

If you have any questions, call our customer service line at (602) 749-7069.

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