APPRAISAL FORMAT: Click to enter format.

Project No.:	enter text	Parcel No.:	enter text
Designation:	enter text	Owner:	enter text
Project ID:	enter text

Name of Appraiser	Date of Appraisal	Revision Date(s)
enter text	choose date	choose date

DETERMINATION OF COMPENSATION

Value of Acquisition:

Land:
enter text	$enter amt
enter text	$enter amt

Improvements (Inclusive of site improvements):
enter text	$enter amt
enter text	$enter amt

Fixtures and Personal Property (considered realty):
enter text	$enter amt
enter text	$enter amt

Easements:
enter text	$enter amt
enter text	$enter amt

Subtotal of Acquisition	$enter amt

Other Compensation:

Permits
enter text	$enter amt
enter text	$enter amt

Depreciation in Current Fair Market Value (not offset by Special Benefits or Cured)
enter text	$enter amt
enter text	$enter amt

Cost to Cure:
enter text	$enter amt
enter text	$enter amt

Cost to Cure Administration and Oversight Fee ($50 min./$2,500 max)	$enter amt
Subtotal of Other Compensation	$enter amt

Just Compensation as of choose date (effective date)	(A)	$enter amt

JUST COMPENSATION ROUNDED	$enter amt

TOTAL COMPENSATION	$enter amt

Uneconomic Remnant
enter text	(B)	$enter amt

Total Just Compensation (A+B less const. permits, easements & cost to cures no longer needed)	$enter amt

JUST COMPENSATION W/ UNECONOMIC REMNANT, ROUNDED	$enter amt

TOTAL COMPENSATION W/ UNECONOMIC REMNANT	$enter amt

The compensation is based on right-of-way plans dated:	choose date

Partial Interests to be divided as follows:
Lessor’s Interest	$enter amt
Lessee’s Interest	$enter amt

Personal Property not considered realty in acquisition, easement or const. permit area:	☐ Yes	☐ No
If YES, please describe:	enter text

REMARKS:	enter text

Client (MDT R/W Bureau or Other entity:	enter text

Property Interest:	enter text

Summary of Appraisal:	enter text

Intended Use of Review:	enter text

Purpose of the Review:	enter text

Scope of Review:	enter text

Completeness, adequacy and relevance of data and appropriateness of adjustments:	enter text

Appropriateness of Appraisal Methods & Techniques:	enter text

I CERTIFY THAT...

initials	The statements of fact contained in this report are true and correct.
initials	This review has been made in conformity with State laws, the Uniform Appraisal Standards for Federal Land Acquisitions and Chapter 3 (Appraisal) of the MDT R/W Manual, as they apply to the review assignment.
initials	I have personally inspected the subject property. If not, explain below:
Remarks: enter text
initials	I have personally inspected the comparable sales applicable to this appraisal. If not, explain below.
Remarks: enter text
initials	I have no direct or indirect present or contemplated future personal interest in the subject property or in any benefit from the acquisition of such property beyond my responsibility as Review Appraiser for the Montana Department of Transportation.
initials	Neither my employment nor compensation is contingent on an action, event or value resulting from the analyses, opinions, or conclusions in, or the use of, this review report.
initials	My conclusions have been reached independently based on factual data of record.
initials	(If reviewer is licensed) As of the date of this report, I have completed the requirements of the continuing education program of the Montana State Board of Real Estate Appraisers.

REVIEWED & APPROVED FOR COMPENSATION

ELECTRONIC SIGNATURE CONSENT

By my signature/typewritten name, I declare under penalty of perjury and the laws of the State of Montana that the foregoing is true and correct and contains no willful falsifications or misrepresentations.

Signature (Typed Name)	Date	Place of Signature (City, State)
Choose a date

If licensed, level of certification & license #:	enter text

No Remarks:☐	Remarks attached: ☐