CONFIDENTIAL INFORMATION - Tell us about your home:
Contact Information:
Name	*Required
Address 1
Address 2
City
State
Zip Code
Day Phone #	*Required
Evening Phone #
Subdivision Name
Email Address
Your Situation:
Do you need to sell your home fast? yes  no
If so, what is your situation?
How soon do you need to sell?
Your Property Information:
Home Style
Stories/Floors
# of Bedrooms	# of Bathrooms
Square Footage
Year Built
Garage?	Select One No Garage 1 car 2 car 3 car
Basement?	Select one No Basement Full Unfinished Full Finished Partial Unfinished Partial Finished
Lot Size/Acreage
How long have you owned your house?
What is the current condition of your home?
What kind of repairs or maintenance items does your house need?
How much do you think the repairs will cost?
How long has the property been for sale?
Is the house currently listed with a realtor? yes     no
Price and Terms:
How much are you asking for your house?
How did you determine your asking price?
If appraised, how much do you think it would be worth?
How much are your mortgage payments?
How many mortgages do you have against the home?
Are your payments current?   yes     no
How much are your annual property taxes?
Are these taxes included in your mortgage payment? yes     no
Would you sell your house for what you owe? yes     no
If we could buy your house in 8 days or less, what is the least you would be willing to accept?
How did you hear about us?
Do you have any additional information or comments that you would like to share with us?

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