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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

The collection of this information is authorized by Section 9 of the Federal Deposit Insurance Act (12 U.S.C. §1819) and Section 202(f) of Title II of the Federal Trade Improvement Act (15 U.S.C. §57a(f)). The FDIC will use this information to respond to your questions and requests for assistance involving activities or practices of FDIC-insured depository institutions. Submitting this information to the FDIC is voluntary. Failure to submit all of the information requested and to complete the form entirely could delay or prevent the response to your request. The information provided by individuals is protected by the Privacy Act, 5 USC §552a. The information may be furnished to the institution which is the subject of the complaint or inquiry; to the Federal or State supervisory authority that has direct supervision over the financial institution; to appropriate Federal, state, local or foreign law enforcement authorities; to a court, administrative tribunal, or a party in litigation; to contractors, agents and other third parties as authorized by law, and in accordance with any of the other routine uses described in the FDIC Consumer Complaint and Inquiry Records (FDIC-30-64-0005) System of Records. A complete copy of this System of Records is available at If you have questions or concerns about the collection or use of the information, you may contact the FDIC’s Chief Privacy Officer at

Privacy Act Statement 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.

Paperwork Reduction Act Statement 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:

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.
Appraisal Management Company
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
* 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. Please do not attach documents or cut and paste into this space. 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:
*Checking this box authorizes the FDIC to respond and investigate (if applicable) your concerns.

FDIC 6910/10 (11-18)
For questions regarding this form, email
Page Updated 12/11/2018

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