Your Information
Mr. Mrs. Ms
First and Last Name:
Email:
Website:
Day Phone:
Evening Phone:
Cell Phone:
Fax Phone:
Your Address:
City, State and Zip
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Best Time to Call:
Anytime
Morning
Afternoon
Evening
Night
Method by which you prefer we contact
you::
Email
Day Phone
Evening Phone
Cell Phone
Fax
How did you hear about us?
Newspaper
Postcard
Mail
Internet
Flyer
Door Hanger
Business Card
Word of Mouth
Promotional Item
Radio
Television
Direct Phone Call
Car Sign
Other
Property Information
Property Type:
Single Family
Condo
Townhouse
Duplex
Triplex
Apartment Building
Apartment Complex
Farm
Raw Land
Commercial Building
Property Address
City, State and Zip
,
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Do you own the property?
Yes
No
If no, who does?
Owner's First and Last Names:
Owner's Phone number:
Owner's Cell Phone number:
Owner's address:
Owner's City, State and Zip
,
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Give the names of any additional ownersif
there are any, up to 3:
,
How Quickly Do You Need
to Sell?
As Soon As Possible (Right now!!!)
Today!!
Within this week
2 weeks
4 weeks
1 - 2 months
2 months plus
2-6 Months
no big hurry
Reason for Sale:
<- please choose ->
Divorce or
Separation
Foreclosure
Death in Family
Job Relocation
Financial
Problems
Avoid Broker
Fees
Speed Up
Selling Process
Probate
Tenant Problems
Inheritance
Bankruptcy
Health Issues
Property
Condition
Need to Move
Fast
Upsizing
Downsizing
Other
If "Other" please specify:
Tell us about your situation. Why are
you trying to sell?
Construction:
Frame
Brick
Block
Vinyl Siding
Aluminum Siding
Brick and Siding
Brick and Frame
Block and Siding
Block and Frame
Stucco
Other
Age of Home:
less than 3
3 - 5 years
5 - 10
years
10 -15 years
16 - 20
years
21 - 30
years
31- 40 years
41 - 50
years
more than 50
years
Square Footage
Stories:
one
two
three
More than threee
split level
Number of bedrooms:
1
2
3
4
5
6
7+
Number of bathrooms:
1
2
3
4+
Number of half bathrooms:
1
2
3
4+
Garage:
None
1 Car Attached
1 Car Detached
1-1/2 Car Attached
1-1/2 Car Detached
2 Car Attached
2 Car Detached
2-1/2 Car Attached
2-1/2 Car Detached
3 Car Attached
3 Car Detached
3-1/2 Car Attached
3-1/2 Car Detached
4 Car Attached
4 Car Detached
5+ Car Attached
5+ Car Detached
Carport
Other
Basement
Slab
Apartment
Crawl Space
Finished
Full
Half
Partially Finished
Unfinished
Walkout
Other
What is the current condition of your
property?
Excellent
Good
Fair
Poor
Terrible
What kind of repairs and maintenance does the house
need?
Is there anyone living in the house?
Yes - Owner Occupied
Yes - Tenant
Yes - Other
No - Unoccupied
How long has the property been for sale?
-
0-7 Days
1-3 Weeks
1-3 Months
3-6 Months
6-12 Months
12-24 Months
More than 24 Months
Are you selling the house with appliances
or other chattels?
Yes No Undecided
Is the house currently listed with a
Realtor® ?
Yes No
If Yes, when does the listing expire?
format: mm/dd/yyyy
If No, has the house been previously
listed?
Yes No
Have you talked to any other investors?
Yes No
Price and Terms
How much are you asking us to pay for your
house?
$
How did you determine your asking price?
Appraisal
Realtor
Tax Assessment
Best Guess
Comparables
If we were to have your house appraised,
How much do you think it would be worth?
$
Are there any other liens on the property
Yes No
Would you sell your house for what you owe
on it?
Yes No Undecided
Would you be willing to sell your house by
allowing us to take over your monthly mortgage payments?
Yes No Undecided
If we were able to buy your house in 7
Days or less, what is the least you could accept?
$
Do need or want to sell your house fast?
Yes
No
Do you have any questions or comments you would like to share with us?