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Sell your house - Tell Us About Your House For a Quick Sale

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C O N F I D E N T I A L
Your Contact Information
*Your First Name
*Your Last Name
*Your Email
*Day-time Phone Number
Your address
Your Street Number
Your Street Name
Your City
Your State
Your Zip
Country
* What's your situation?
Why are you selling?
*When do you need to sell your house?
Property Information
*Is the house currently listed
with a Realtor?
Yes No
* If No, has the house been previously
listed?
* What kind of repairs or
maintenance does the
house need?
*How much do you think
these repairs will cost?
$ e.g. 5000 (not 5,000)
*Property Type
*Approx. Square Feet
*Year Built
*Bedrooms
*Bathrooms
*Pool
Yes No
*Garage?
Yes No
*Fenced Yard?
Yes No
*Style?
Ranch Split-Level Post-Modern
Office Condo Retail Strip Center Office Building
*Exterior Wall Finish?
All Brick Siding & Brick/Stone All Siding Stucco Other
Price And Terms
  1st Mortgage 2nd Mortgage
*Balance $ $
*Monthly
Payment		 $ $
*Are Payments
Current?		 Yes No Yes No
*If Not How Far
Behind?		 $ $
*Total Lien Amount
(if more than 1,
list each separately)?
*Are your property taxes
and insurance included in
your monthly mortgage
payment?
Yes No
*If we were to have your
house appraised, how much
do you think it would be worth?
$
*Would you sell your house
for what you owe on it?
Yes No Undecided
*If we were able to buy
your house in 7 Days or less,
what is the least you could
accept?
$ e.g. 5000 (not 5,000)
How did you hear about us.?
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