Form 1 Appraisal Complaint Form

OMB Control No. 1557-0314
Expiration Date: 05/31/2022

APPRAISAL COMPLAINT FORM
Please fill in this form completely. Mail or fax this completed complaint form to:
Office of the Comptroller of the Currency
Customer Assistance Group
1301 McKinney Street, Suite 3450
Houston, TX 77010-9050
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. §

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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)
Phone
______________________________________________
Address, City, State, Zip Code

__________________________
Email

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 __________________________

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
Address of the Property Involved
_______________________________
Residential 1-to-4 Family
Commercial or Multi-Family (over 4 units)
_______________________________
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Have you tried to resolve your complaint with anyone? Yes

No

If Yes, date of contact: _______________ 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.
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

If a valid OMB Control Number does not appear on this form, you are not required to complete this form.
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