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Last Name
First Name
Initial
Home Phone
Cell Phone
E-Mail Address
Prefered Contact Method





Property Street Address
Property City
Property State
Property Zip Code
Reason for Selling















The property is currently:
Property type
Number of Units
Unit 1 - Bedrooms
Unit 1 - Bathrooms
Unit 1 - Air Conditioning
Unit 1 - Parking
Unit 2 - Bedrooms
Unit 2 - Bathrooms
Unit 2 - Air Conditioning
Unit 2 - Parking
Mortgage Company Name
Current Mortgage Type
Are you behind on your payments?
If so, how many months?
Total Amount owed in back payments
Have you received a foreclosure notice?
Has a foreclosure sale date been set?
If so, what is the sale date
Existing 1st mortgage balance
Existing 2nd Mortgage balance
Existing 3rd Mortgage balance
Other liens, assessments on property
Bankruptcy Status
Tell us about your situation
How motivated are you to sell?
What is the Retail Value of Property
How did you determine the retail value
Total cost of needed repairs
Describe items and breakdown costs
What price are you asking
All cash, quick close price?