3P Rev. 10-10-16 All previous versions are obsolete.
© BLB Resources, Inc. 2016 All rights reserved.
3P: CT, ME, MA, NH, NJ, NY, RI, VT
Termite Report Request
Please note: Termite inspections are ordered automatically on all properties where the buyer is obtaining
FHA financing. If you would like a copy of this report, please complete this form and submit via fax to
(248) 301-6647 or email to
3Paddenda@blbresources.com.
Date: __________________
Property Information
FHA Case Number: __________________________
Property Address (include city, state & county):
__________________________________________________________________________________
Purchaser (s): ___________________________ ___________________________________________
Selling Broker Information
Brokerage Company Name: ___________________________________________________________
Office Phone Number: ____________________ Fax Number: __________________
Selling Agent’s Name: _______________________________________________________________
Cell Phone Number: _______________
Email: ____________________________________________________________________________
_____________________________________________________ __________________
Purchaser Signature (Required) Date
_____________________________________________________ __________________
Purchaser Signature (Required) Date
______________________________________________________ __________________
Selling Agent Signature (Required) Date
This section for BLB Resources, Inc. use only
Date Termite Report Sent: _________________________
Method: Email US Mail Fax
Sent by:_______________________________________________