EML REGULATORY COMPLIANCE AUDIT REQUEST FORM

 

Name of Potential Client:                                                     ______________________________________

 

Address:                                                                                _______________________________________

 

                                                                                                _______________________________________

 

Client Contact:                                                                      _______________________________________

 

Telephone Number:                                                             (         )__________________________________

 

Fax Number:                                                                         (         )__________________________________

 

E-mail Address:                                                                   _______________________________________

 

Property Name:                                                                   _______________________________________

 

                                                                                                                 __ Commercial      __ Industrial

 

Address of Property:                                                          _______________________________________

     

                                                                                              ________________________________________

Comments: _________________________________________________________________________               

 

__________________________________________________________________________________

 

__________________________________________________________________________________

 

__________________________________________________________________________________                                                      

   

 

(for EML use only)

 

Fee Proposed:                                                                       _______________________________________

               

Proposal Accepted:                                                              __ Yes                                      __ No

 

If No, Reason For Rejection:                                              _______________________________________

 

 

Report Sent:                                                                          Date: _________   How Mailed: _________

 

Invoice Sent:                                                                         Date: _________   Fee: _________