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Your Contact Information
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First Name:
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Last Name:
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Daytime Phone:
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Evening Phone:
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Cell Phone:
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Best Time To Call:
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E-mail Address:
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Your Situation
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Do you need to sell FAST
or STOP Foreclosure?
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YesNo
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Why are you selling?
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Estimated Value?
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What is your asking price?
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How was the asking price determined?
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If we could offer Quick Cash
and Close Quickly,
What would be the minimum amount you would accept?
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How much was your
original loan for the house?
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What is the current
balance on the loan?
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What is the current
mortgage payment(s)?
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Does your payment
include taxes and insurance?
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YesNo
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Are you behind on
payments or taxes?
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YesNo
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Are you willing to sell for
what is owed on the house?
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YesNo
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Property Information
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Property Address:
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City, State & Zip:
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How long have
you owned the house?
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What year was house built?
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What type of construction?
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What type of roof?
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How many Bedrooms?
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How many Bathrooms?
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Is there a Basement?
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YesNo
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Is the Basement finished?
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YesNo
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Is there a Garage?
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Is the house vacant or occupied?
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VacantOccupied
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If occupied, when will it
become available? (date)
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Does the house need
repairs or upgrades?
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YesNo
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In your opinion,
what repairs are needed?
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Are you listed with a Realtor?
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YesNo
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How did you hear about us?
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