Contact Information
Name:
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Property Address:
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Property City:
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Property State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
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Property Zip Code:
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Home Phone:
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Cell Phone:
Work Phone:
Fax:
Email Address:
*
Best time to contact you?:
Early Morning
Morning
Lunchtime
Afternoon
Evening
Anytime
General Information
Why are you selling?
When would you like to close?
mm/dd/yyyy
Who currently occupies the property?
Owner
Tenant
Vacant
Is the house currently listed?
Not Currently Listed
For Sale By Owner
Listed w/ Real Estate Agent
If yes, how long has it been listed?
months
If yes, what is the current listing price?
Property Information
How many bedrooms?
1
2
3
4
5
6
7
8
9
10+
How many bathrooms?
1
1.5
2
2.5
3
3.5
4
4.5
5+
What is the approximate square footage?
What type of home?
Single Family
Condo
Town Home
Duplex
Triplex
5+ Apartment
Mobile In Park
Double Wide
Modular
Commercial
Land
Other
Does the house need repair?
Yes
No
If the house needs repair, please explain what they are an an
estimate of what they will cost:
Financial Information
What are you asking for the house?
If you were to have the house appraised, what do you think it
would appraise for?
1st Mortgage:
What is the balance of your 1st mortgage?
What is your 1st mortgage payment (including taxes and insurance)?
Are your 1st mortgage payments current?
Yes
No
About to be behind
If not, how far behind are they?
2nd Mortgage:
What is the balance of your 2nd mortgage?
What is your 2nd mortgage payment (including taxes and insurance)?
Are your 2nd mortgage payments current?
Yes
No
About to be behind
If not, how far behind are they?
Are their any other liens we should know about?
Can you sell us your house for the total balance of your loan(s)?
Yes
No
Are you currently in bankruptcy?
No
Yes – Chapter 7
Yes – Chapter 13
If we were to pay you all cash, what is the least you would take?
Marketing
How did you hear about us?
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