Form FR 1379d FR 1379d Appraisal Complaint Form

FR 1379d
OMB Number 7100–0135
Expires February 28, 2023
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Board of Governors of the Federal Reserve System

Interagency Appraisal Complaint Form
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, 1820, and 1844 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 (www.ncua.gov/privacy/website-privacy-policy).
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.

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.
Whistleblowers: Federal and state laws offer protection for whistleblowers.
Your Information

Who are you? (Please check the appropriate box.)
Individual Property Owner
Business Property Owner
Financial Institution Lender
Non-Financial Institution Lender
Mortgage Broker
Appraiser
Appraisal Management Company
Other:

Name (First, Last or Business)

Street Address

City

State

Zip Code

Area Code / Phone Number

Email Address

Who are you complaining about? (Check all that apply.)
Appraiser
Lender
Are you employed by the subject of your complaint?

Appraisal Management Company
Other:
Yes

No

Please provide contact information regarding the person or entity you are complaining about. If more than one, please
provide information in the “Describe your complaint” section.
Name (First, Last or Business)

Area Code / Phone Number

Street Address

City

State

Zip Code

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:
Secretary, Board of Governors of the Federal Reserve System, 20th and C Streets, NW, Washington, DC 20551; and to the Office of Management and Budget, Paperwork Reduction
Project (7100-0135), Washington, DC 20503.

01/2020

FR 1379d
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Interagency Appraisal Complaint Form—Continued
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– 4 Family

Address of the Property Involved

Commercial or Multi-Family (over 4 units)

Street Address

Have you tried to resolve your complaint with anyone?
If Yes, date of contact:

Yes

City

State

Zip Code

No

Who did you contact?
(MM/DD/YYYY)

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: https://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 (MM/DD/YYYY)
01/2020