Language English (US) Owner Information "Don't Forget To Confirm Subscription! This Way If Right Now Isn't A Good Time You'll Have This Form and Info Saved In Your Email!" Full Name * First Name Last Name Phone Number * - Area Code Phone Number Mobile Number - Area Code Phone Number E-mail * Best Time to Call Morning Afternoon Evening Property Information Address Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Curacao Cyprus Czech Republic Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Nagorno-Karabakh Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Turkish Republic of Northern Cyprus Northern Mariana Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Republic of the Congo Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia South Sudan Spain Sri Lanka Sudan Suriname Svalbard eSwatini Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Transnistria Pridnestrovie Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands Isle of Man US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Bedrooms: 1 2 3 4 5 6 7 8 9 10+ Bathrooms: 1 2 3 4 5 6 7 8 9 10+ What is the approximate square footage: Year Built: How many stories? Garage: None 1 car Attached 1 car Detached 1.5 Car Attached 1.5 Car Detached 2 Car Attached 2 Car Detached 2.5 Car Attached 2.5 Car Detached 3 Car Attached 3 Car Detached 3.5 Car Attached 3.5 Car Detached Carport Other What is the current condition of your property? Excellent Good Fair Poor Terrible How many years have you owned this home: What kind of repairs and maintenance does the house need? How much do you think these repairs will cost in dollars? $ Is there anyone living in the house? Yes-Owner Occupied Yes-Tenant No-Unoccupied How long has the property been for sale? Is the house currently listed with a ®Realtor? Yes No If No, has the house been previously listed? Yes No If Yes, when does the listing expire? Your Situation What's your situation? Why are you selling? Pricing Information What do you think your house is worth? $ How much are you asking for your house? $ How did you determine the value? Appraisal Realtor Tax Assessment Best Guess Comparable What is the least you would accept if we closed quickly? Are you looking to sell your house for what you owe? Yes No Maybe How soon are you planning on moving? 1st Mortgage 2nd Mortgage Balance: Loan Balance? Loan Balance 2? Interest Rate %: What's your interest rate? What's your interest rate 2? Payment: What's your monthly payment? Monthly payment 2? Type of rate? Fixed Adj Type of rate 2? Fixed Adj Payments Current? Yes No If No, how far behind? $ Are your property taxes and insurance included in your monthly mortgage payment? Yes No Do you pay Homeowner/Condo Association dues? If so, how much per year? $ May we take over your payments until we get the house sold? Yes No Undecided How did you hear about us? Do you have any questions or comments you would like to share with us? If we paid cash and closed in 21 days what is the lowest amount you would be willing to accept? 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