First Name (required)
Last Name (required)
Day Phone (required)
Evening Phone (required)
Email (required)
Address (required)
City (required)
State (required)
Zip Code (required)
Why are you selling your home? (required)
Bedrooms(required) ---1234567 or more
Bathrooms (required) ---1234567 or more
Square Footage (required)
Garage (required) ---none11.522.533.544.55 or more
Basement (required) ---yesno
Lot Size Acreage (required)
Year Built (required)
Construction (required) ---WoodBrickVinyl Siding
How long have you owned this house?: (required)
What is the current condition of the property?: (required) ---ExcellentGoodFairPoorTerrible
What kind of repair maintenance does the house need?:
How much do you think these repairs will cost?: (required)
Is there anyone living in the house?: ---Yes/OwnerYes/TenantNo
Is the Property currently listed for sale?
Is the house currently listed with a realtor?: ---YesNo
If yes, when does the listing expire?:
If no, has the house been previously listed?: ---YesNo
1st Mortgage Balance :
1st Mortgage Payment :
1st Mortgage Interest Rate:
Fixed or Adjustable? : ---YesNo
Payments Current: ---YesNo
If No, how far behind?:
2nd Mortgage Balance :
2nd Mortgage Payment :
2nd Mortgage Interest Rate:
3rd Mortgage Balance :
3rd Mortgage Payment :
3rd Mortgage Interest Rate:
How much are your total annual property taxes?:
Are your property taxes and insurance included in your monthly mortgage payment?: ---YesNo
Do you pay Homeowner/Condo Association dues?: ---YesNo
If so, how much per year?:
Comments (required)