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Tell Us About Your House

Filling out this form and submitting it now is the quickest and easiest way to find out how we can help your family. We'll get back to you very soon to discuss our options!

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Seller's Information
Name
Email
Day Phone
Evening Phone
How did you hear about us?	Choose One Street Sign Newspaper Ad Email News Article Post Card Letter Ad Magazine Flyer Grocery Shopper Car Sign Search Engine Internet Ad Radio Billboard Business Card Referral Other
Street Address
City
County
State
Zip Code
Subdivision Name (if any)
Let's talk about the numbers...
How much do you owe on your house?
1st Mortgage Balance
1st Mortgage Payment
1st Mortgage Holder
If you have a second mortgage on this house...
2nd Mortgage Balance
2nd Mortgage Payment
2nd Mortgage Holder
If you have an equity line on this house...
Equity Line Balance
Equity Line Payment
Equity Line 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
If yes - enter case number:
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
What is the most you think your house would bring?
Is the house	occupied unoccupied
Does the house need repairs?	yes no
If "yes," what kind?
Describe the house...
Ranch 2-Story Split Foyer Split Level	All Brick Brick Siding Wood Siding Vinyl Siding Stucco
# of Bedrooms # of Baths	Square Footage Lot Size
Central Air Yes No Number of Units	Sewer or Septic Age of Roof
Crawl Space Slab Finished Basement Unfinished Basement	Garage Carport Number of Cars
When was the house built?
How long have you owned the house?
It sounds like a nice place, why are you selling?
Is it listed with an agent?	yes no
If yes, when does the listing expire?