Your Contact Information
First Name:
Last Name:
Daytime Phone:
*
Evening Phone:
*
Cell Phone:
*
Best time to call?
How did you hear about us?
Select One
Letter
Postcard
The Bulletin Board
Newspaper
Street Sign
Truck Sign
Referral
Radio
Television
Business Card
Billboard
Search Engine
Other
* Include area code
Your Situation
Tell us a little about your situation.
Why are you selling?
How soon do you need to sell?
Select One
Right Now
Within 2 weeks
Within 1 month
Within 2 months
More than 2 months
Just whenever
How long have you owned the house?
yrs
mths
How long has the property been for sale?
yrs
mths
Is the house currently listed with a realtor?
Yes
No
- If Yes, when does the listing expire?
mm/dd/yyyy
- If No, has the house been previously listed?
Yes
No
Let’s talk about the numbers
Are all of the rates fixed?
Yes
No
Are property taxes and insurance included in your payment?
Yes
No
Do you pay Homeowner/Condo Association dues?
Yes
No
-
If so, how much per month?
$
So, including everything, the total monthly payment is:
$
Are the payments current?
Yes
No
-
If No, how far behind?
Select One
1 month
2 months
3 months
4 or more months
Have you received a foreclosure warning letter from your lender?
Yes
No
- If yes, date received:
mm/yyyy
Has a Foreclosure Sale Date been set?
Yes
No
-
If yes, what is the sale date?
mm/dd/yyyy
Is the house attached to a bankruptcy?
Yes
No
Your Property Information
Address 1:
Address 2:
City:
State:
Zip:
County:
Subdivision (if any):
What type of condition is the house in?
EXCEPTIONAL
(The house and property are in perfect A-1 condition)
GOOD
(The house could probably use some fresh paint and carpet, otherwise it’s in A-1 shape)
FAIR
(The house needs a little more than just paint and carpet, etc. to get it into A-1 shape)
POOR
(It’s going to take significant time and money to get the house into A-1 condition)
UGLY
(This house looks Ugly!)
If your house were in A-1 condition, what do you think it would be worth?
$
If your house were in A-1 condition, what do you think it would rent for?
$
Is the house currently occupied?
Yes
No
-
If Yes, occupied by:
Select One
Tenants
Owner
House Type:
Select One
Ranch/One-story
Two Story
Split Level
Split foyer
Town House
Condominium
Mobile Home
Construction:
Select One
All Brick
Brick & Stucco
Brick & Siding
Vinyl Siding
Stucco
Wood siding
No. of bedrooms:
No. of bathrooms:
Square Footage:
Year Built:
Age of Roof:
yrs
Property includes:
Are there any other comments that you would like to make?