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Name*		Day Phone*	Evening Phone*
Email Address*		Street Address*
City*		State*	Zip Code*
Subdivision Name (if any)		How did you hear about us? Street Sign Search Engine Newspaper Ad Billboard Referral Other
About your tenants...
Tenants? yes no If yes, how long have they rented?
Do you have a lease? yes no If yes, expiration?
How many payments did they make in the last 12 months?
What is the Monthly Rent being charged? ffffffff
What are the Monthly Management Fees? fffffff
What are the Monthly Utilities? fffffffffffffffffffffffffffff
What are the Other Monthly Costs? ffffffffffffffffffff
Let's talk about the numbers...
How much do you owe on your house?*
1st Mortgage Balance*	1st Mortgage Payment*	1st Mortgage Holder*
2nd Mortgage Balance	2nd Mortgage Payment	2nd Mortgage Holder
Do you have an equity line on this house?
Balance	Payment	Holder
So the total monthly payment is* Are the payments current? Yes No If no, how far behind? Is the house attached to a bankruptcy? Yes No How much do you need now for your house? What do you think your house is worth? How did you arrive at that number? Real Estate Agent  Appraisals Comparables Tax Assessment Guess Does the house need repairs? yes no If "yes," what kind? Describe your house... Ranch 2-Story Split Foyer Split Level Sq. Footage All Brick Brick Siding Wood Siding Vinyl Siding Stucco Lot Size # of Bedrooms # of Baths Formal Living Rm Formal Dining Rm Fireplace Ceiling Fans Fenced Pool Sewer Septic Crawl Space Slab Basement Finished Age of Roof Unfinished Garage Number of Cars Central Air Number of Units Carport When was the house built? How long have you owned the house? Why are you selling? Is it listed with an agent? yes no If yes, when does the listing expire?

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