Name
*
First Name
Last Name
Email
*
Phone
*
(###)
###
####
What is your situation? Why are you selling?
Are you facing foreclosure?
I need to sell/move
Now
In a few weeks
In a month or two
In the next year
I am in no hurry
Property Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Type of Property
Single Family Home
Duplex
Mobile Home
Townhome
Condo
Multi-family (1-4 units)
Multi-family (5+ units)
Land / Lot
Commercial
Mixed-Use
Other
When did you purchase this property?
MM
DD
YYYY
Is there anyone living in the property?
Yes - owner-occupied
Yes - tenant
No - vacant
What is the current condition of the property?
Excellent
Good
Fair
Poor
Terrible
What kind of repairs and maintenance does the property need?
How much do you think these repairs will cost?
Less than $1,000
$1,000 to $5,000
$5,000 to $10,000
$10,000 to $15,000
$15,000 to $20,000
$20,000 to $30,000
$30,000 to $50,000
$50,000 to $75,000
$75,000 to $100,000
> $100,000
Is the house currently listed with a Realtor?
If Yes, when does the listing expire?
MM
DD
YYYY
Interest Rate
Rate type
Payments current?
If No, how far behind?
Interest Rate
Rate type
Payments current?
If No, how far behind?
Interest Rate
Rate Type
Payments Current?
If No, how far behind?
Are your property taxes and insurance included in your monthly mortgage payment?
How have you determined your asking price?
Appraisal
Realtor
Tax Assessment
Best Guess
Comparable Sales
If you have a Mortgage, would you sell your house for what you owe on it?
Would you be willing to receive any of your equity, if applicable, in the form of monthly payments?
Would you be willing to sell your house by allowing us to take over your monthly mortgage payments?
How did you hear about us?
*
Yard Sign
Vehicle Sign
Post Card
Referral - Agent
Referral - Family/Friend
Social Media - Facebook
Social Media - Other
Open House
Business Card
TV
Radio
Other
Do you have any questions or comments for us?
