Interagency Appraisal Complaint Form

APPRAISAL COMPLAINT FORM
OMB Control No. XXXXX Expiration Date: XX/XX/XXXX

Please fill in this form completely. Mail or fax this completed complaint form to:

Office of the Comptroller of the Currency
Customer Assistance Group
P.O. Box 53570
Houston, TX 77052
1-713-336-4301 (Fax)

Interagency Appraisal Complaint Form
Purpose: This form collects information about complaints of non-compliance with
the appraisal independence standards and the Uniform Standards of Professional
Appraisal Practice, including complaints from appraisers, individuals, financial
institutions, and other entities.
Complaint Process: Your complaint will be reviewed by the appropriate
regulator(s). Please do not submit documents with your complaint, as the
regulator(s) will contact you if more information is needed. Please note the
regulator(s) may not be able to provide the resolution you request because of legal
and other constraints. For example, regulator(s) considering a complaint do not
have jurisdiction to directly award damages, settle fee disputes, or act as your
attorney or expert witness. A regulator’s review of your complaint will focus on
potential violations of applicable law or regulatory policy and could result in a
regulator taking action(s) against the entity about which you are complaining.
Paperwork Reduction Act of 1995: The burden for this collection of information
is estimated to take 30 minutes per response. This includes time for reviewing the
instructions, gathering needed information, and completing and reviewing the form.
An agency may not conduct or sponsor, and a person is not required to respond to a
collection of information unless it displays a currently valid OMB control number. If
you have comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this burden, send
comments to: Legislative and Regulatory Activities Division, Office of the
Comptroller of the Currency, Washington, DC 20219; Comments/Legal ESS, Federal
Deposit Insurance Corporation, 550 17th Street NW, Washington, DC 20429; NCUA
PRA, National Credit Union Administration, 1775 Duke Street, Alexandria, Virginia
22314.
Privacy Notice: The information you are providing is being collected pursuant to
the individual authorities of the federal financial institution regulators (12 U.S.C. §§
1481, 1464, 1756, 1766, and 1820 in connection with a complaint made pursuant
to 12 U.S.C. § 3351(i). The information provided will be used to ensure the
appropriate regulator receives your complaint and by the regulator to review and
respond to your complaint. In order to review and respond to your complaint, the
appropriate regulator may disclose your information consistent with the routine uses
listed in the regulators’ respective Privacy Act Statement:
OCC (www.helpwithmybank.gov/policies/policies-privacy.html);
FDIC (www.fdic.gov/consumers/questions/Priv_statement.html);
FRB (www.federalreserve.gov/privacy.htm); and
NCUA (http://www.ncua.gov/about/pages/Privacy.aspx).

Do not include any information in your complaint you consider confidential or do not
want disclosed during the complaint review process. While completing this form is
voluntary, failure to provide all of the information may delay or prevent the
appropriate regulator from reviewing your complaint.
Whistleblowers: Federal and state laws offer protection for whistleblowers.

Your Information

Name (First, Last or Business)
Address, City, State, Zip Code
(
Phone

)

-

Email
Who are you? Please check the appropriate box.
Individual Property Owner

Mortgage Broker

Business Property Owner

Appraiser

Financial Institution Lender

Appraisal Management Company

Non-Financial Institution Lender

Other

Who are you complaining about? Check all that apply.
Appraiser

Appraisal Management Company

Lender

Other

Are you employed by the subject of your complaint?

Yes

No

Please provide information regarding the person or entity you are
complaining about. If more than one, please provide information in the
“Describe your complaint” section, below.

Name (First, Last or Business)
(
Phone

)

-

Address, City, State, Zip Code

What is the nature of your complaint? Check all that apply.
Appraiser independence
Non-compliance with Uniform Standards of Professional Appraisal Practice
Improper (or attempted improper) influencing of an appraiser or the appraisal
process
Removal or exclusion from an approved appraiser list or addition to a “do not
use” list
Appraisal fee-related issue
Appraisal report inaccurate
Other
Please provide information about your complaint.

Type of Property
Residential 1-to-4 Family

Commercial or Multi-Family (over 4 units)

Address of the Property Involved:

Have you tried to resolve your complaint with anyone?
If Yes, date of contact:
Who did you contact?
At what company or government agency?

Yes

No

Describe your complaint.
Briefly describe your complaint. Do not submit any documents with your complaint. You
will be contacted if more information is needed.

For more information on appraiser independence or the Uniform Standards of Professional
Appraisal Practice (USPAP), go to: http://ReferMyAppraisalComplaint.ASC.gov.

I certify that I am the named individual or business (or their designee) filing this
complaint and the information in this complaint is true and correct to the best of my
knowledge and belief.

_________________________________________
Signature

_______________________
Date