Please Tell Us a Little Bit of Information About Your House:
First Name :
Last Name :
Your Address :
City :
State :
Zip Code :
Phone :
Fax :
Email :
Why Are You Selling? :
Are There Any Existing Mortgages/Loans? :
Yes
No
What is the Approx. Balance of the 1st Mortgage? :
What is the Monthly Payment? :
Does this payment include taxes & insurance? :
Yes
No
Is the First Mortgage Current or Late? :
Current
Late
If Late, How Many Months? :
Is There a 2nd or 3rd Mortgage? :
Yes
No
If Yes, What Are the Balances? :
What Are the Monthly Payments? :
Is/Are the 2nd/3rd Mortgages Current or Late? :
Current
Late
If Late, How Many Months? :
Does the House Need Repair? :
Yes
No
If Yes, What Repairs Are Needed? :
If You Were to Estimate, How Much Would the Repairs Cost? :
Less Than $5000
$5000-$10000
$10000-$15000
$15000-$20000
$20000-$25000
$25000-$30000
More Than $30000
If You Were to Have the House Appraised, How Much Do You Think It Would Be Worth? :
If I Were to Offer You Fast Cash, and Close Quickly, What Would be the Least You Could Accept? :
What is the Address of the House You Wish to Sell?
House Number & Street Name: :
City, State: :
Zip Code: :
How Many Bedrooms? :
Efficiency/Studio
1
2
3
4
5
6
How Many Full Bathrooms? :
1
2
3
4
How Many 1/2 Bathrooms? :
None
1
2
3
What is the Approximate Square Footage? :
What is the Approximate Age of the House? :
What is the Construction of the House? :
Concrete Block
Brick
Frame
Other
What Condition Is the Roof In? :
Excellent/New
Good
Bad
Falling Down
Roof?
Is the House Vacant or Occupied? :
Vacant
Occupied
When Do You Want to Move/Close? (Date) :
Will You Sell The House For What You Owe? :
Yes
No
Comments :
Anti-Spam
Challenge :
