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Contact Information

Name:

First Name

Last Name

Address:

Address1

Address 2

City

State

Zip

Home Phone:

Area Code

Phone First 3

Phone Last 4

Cell Phone:

Area Code

Phone First 3

Phone Last 4

Other Phone:

Area Code

Phone First 3

Phone Last 4

Fax:

Email:

Best time to contact?:

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General Information

Why are you selling?:

When would you like to close?:

Is the house currently vacant?:

Yes

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Property Information

Address:

Address1

Address 2

City

State

Zip

What is the Property type?:

How many bedrooms?:

How many bathrooms?:

What is the approximate square footage?:

What is the lot size?:

What is the type of construction?:

Does the house need repair?:

Yes

If repairs are needed, please explain what they are?:

Comments:

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Financial Information

What are you asking for the house?:

If we were to have the house appraised, what do you think it would appraise for?:

Are you offering any terms?:

What is your loan balance?:

What is your payment?:

Can you sell us your house for the total balance of your loan(s)?:

Yes

If not, how much cash do you need right now?:

If you take some cash now, how much will you need later to complete this transaction?:

Would you like to hear about other creative ways we could buy your home?:

Yes

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Property Photos (jpg images only, no larger than 800px X 800px)

Front: