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About you...
Name Required
Day Phone Required (###) ###-####
 
Email Address
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Best Time to Call
 Cell Phone (###) ###-####
How did you hear about us?
Fax (###) ###-####
About your situation...
Do you need to sell your house fast? Yes No
If so, what is your situation? Why are you selling?
When do you want to move?
About your property...
Street Address Required
 		 County
City Required
  		State Required
 
Subdivision Name
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About your house...
Bedrooms
 Bathrooms
 Garage
Lot Size
Sq. Footage
 Year Built
Exterior
 Style
Foundation
 The house is...
Describe any unique features of the house in the box below
How long have you owned the house? (in years)
Does the house need repairs? Yes No
What is the estimated cost of repairs?
Describe any needed repairs in the box below
Is the house listed with an agent? Yes No
If yes, when does the listing expire? MM/DD/YYYY
About the numbers...
What is your asking price?
How did you arrive at that number?
If we had the house appraised,
what do you think the house is worth?
  1st Mortgage 2nd Mortgage 3rd Mortgage
Lender Name:
Balance:
Payment:
Interest Rate: % % %
Interest Only Loan: Yes No Yes No Yes No
Payments Includes:

Taxes
Insurance
PMI

    
Payments Behind?: Yes No Yes No Yes No
If so, what amount?:
Are there any liens or back taxes? Yes No
If so, what amount?
Is the house attached to a bankruptcy? Yes No
Have you received a foreclosure notice? Yes No
Has a foreclosure date been set? Yes No
If so, what is the foreclosure date? MM/DD/YYYY
Would you sell your house for what you owe on it? Yes No Undecided
Would you be willing to receive any of your equity,
if applicable, in the form of monthly payments?		 Yes No Undecided
Would you be willing to sell your house by
allowing us to take over your monthly payments?		 Yes No Undecided
Comments...
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