First Name *
Last Name *
Email *
Home Phone*
Cell Phone
Work Phone
Property Address*
Property Address*
How did you hear about us? *
City*
State*
Zip*
Square Footage*
Property Type
# of Bedrooms
# of Bathrooms
Garage
Approx Home Value*
Source of Value
Asking Price*
Asking Price for CASH*
Listed with a Realtor?
Reason for selling
Are repairs needed
List any repairs needed
List Price
1st Mortgage
2nd Mortgage
%
%
$
$
$
$
Balance*
Interest
Payment
Balance
Interest
Payment
Payments Current?
# of months behinkd
Amount behind
$
Comments
Other liens or mortgages?
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