* First Name:
* Last Name:
* Email:
* Phone:
* Cell Phone:
* How Did You Hear About Us?
* Address:
* City:
* State:
* Zip:
* Property Type:	SFR 2 Story Condo Ranch Other
* Square Footage:
* How Many Bedrooms?	1 2 3 4 5+
* How Many Bathrooms?	1 2 3 4 5+
* Garage:	Yes No
* Pool:	Yes No
* Listed With A Realtor?	Yes No
* Are You The Property Owner?	Yes No
* Other Features:
* Is The House Vacant?	Yes No
* Why Are You Selling?
* What Is Your Asking Price?
* How Much Do You Think It Will Appraise For?
* How Did You Arrive At This Figure?
* Will You Sell It For What You Owe?	Yes No Maybe
* If I Can Give You A Full Retail Price, Can You Wait 12-24 Months For It If I Pay Your Mortgage In The Meantime?	Yes No Maybe
* Please List Repairs Needed:
* Estimated Cost Of Repairs Needed:
* First Mortgage Balance:
* Adjustable Or Fixed Payment:	Adjustable Fixed N/A
* First Mortgage Monthly Payment:
* Does This Include Taxes/Insurance?	Yes No
* Are The Payments Current?	Yes No N/A
* If Not How Many Payments Are You Behind?	1 2 3 4+ N/A
* Second Mortgage Balance:
* Adjustable or Fixed Payment:	Adjustable Fixed N/A
* Second Mortgage Monthly Payment:
* Are The Payments Current?	Yes No N/A
* If Not How Many Payments Are You Behind?	1 2 3 4+ N/A
* Are There Any Other Liens Against The Property?	Yes No
* If Yes For How Much?
What Will You Do If I Can't Help You?
Comments/questions:
	* = Required Field