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Federal Deposit
Insurance Corporation

Each depositor insured to at least $250,000 per insured bank

Interagency Appraisal Complaint Form

FDIC 3064-0190  Expiration Date: 5/31/2019
FRB 7100-0135  Expiration Date: 8/31/2019
OCC 1557-0314  Expiration Date: 5/31/2019

Privacy Act Statement

Collection of this information is authorized by 12 U.S.C. §§ 1818 and 1819 and 15 U.S.C. § 57a(f). The information you provide to the FDIC on this form will be used to investigate and respond to your complaint or inquiry. The information you provide may be disclosed to the institution which is the subject of the complaint or inquiry and to any third party sources, when necessary to investigate or resolve the complaint or inquiry; to the Federal or State supervisory authority that has direct supervision over the financial institution that is the subject of the complaint or inquiry; to appropriate Federal, state or local authorities agencies if a violation or possible violation of a civil or criminal law is apparent; to a congressional office in response to an inquiry made at your request; to a court, magistrate or administrative tribunal in the event of litigation, or in accordance with the other "routine uses of records" listed in the FDIC's Consumer Complaint and Inquiry System of Records, # 30-64-0005. Completing this form is voluntary, but failure to provide all of the information may delay or preclude investigation of your complaint or inquiry.

Last Updated 11/20/2017

Paperwork Reduction Act Statement

Public reporting burden for this collection of information is estimated to average .25 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and review the collection of information.

Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Paper Reduction Act Clearance Officer, Legal Division, Federal Deposit Insurance Corporation, 550 17th Street, N.W., Washington, D.C. 20429, and the Office of Management and Budget, Paperwork Reduction Project (3064-0134), Washington, D.C. 20503.

An agency may not conduct or sponsor, and a person is not required to respond to, a collection unless it displays a currently valid OMB control number.

Last Updated 11/20/2017
 

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.

Do not include any information in your complaint that 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.

* Required Fields
Your Information:
 
Salutation
Business Name
Phone numbers must be numeric, no dashes or parenthesis (ex:1234567890)
Phone Number
*Mailing City *Mailing State/Province  
*Mailing Zip/Postal Code Zip Ext  
*Mailing Country
 
* Who are you? Please check the most appropriate option.
 
* Who are you complaining about? Check all that apply.
Appraiser
Appraisal Management Company
Lender
Other   
Are you employed by the subject of your complaint?
* 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.
*Business Name
Phone numbers must be numeric, no dashes or parenthesis (ex:1234567890)
Phone Number
*Mailing City *Mailing State/Province  
*Mailing Zip/Postal Code Zip Ext  
 
 
* 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 the Property
 
Address of Property
*City *State  
*Zip Zip Ext  
 
Have you tried to resolve your complaint with anyone?
MM/DD/YYYY   *Who did you contact?  
*At what company or government agency?
 
* 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.
 
*Checking this box authorizes the FDIC to respond and investigate (if applicable) your concerns.
 
 

Last Updated 12/11/2017

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