Personal Information
First Name	*	Last Name	*
Email Address	*	Day Phone	*
Best Time to Call	- Select - Any Time Morning Afternoon Evening Night *

 

Your Situation
Do you need to sell your house fast?	Yes   No
Reason

 

Property Address
Address	*	City	*
Property Information
Bedrooms		Bathrooms
Square Footage		Year Built
Years Owned?	How long have you owned this house?	Current Condition	- Select - Excellent Good Fair Poor Terrible
Repairs and Maintenance	What kind of repairs and maintenance does the house need?
Cost of Repairs	$  How much do you think these repairs will cost?	Occupied?	- Select - Yes - Owner Occupied Yes - Tenant No - Unoccupied  Is there anyone living in the house?

 

Price & Terms
Asking Price	$ *	Price Determined by?	- Select - Appraisal Realtor Tax Assessment Best Guess Comparables Amount Needed to Move *
Your Estimated Worth of House	$ *  If we were to have your house appraised, how much do you think it would be worth?
Liabilities
Homeowner Association Dues	$  Do you pay Homeowner/Condo Association dues? If so, how much per year?
Questions
Would you sell your house for what you owe on it? *			Yes   No   Undecided
Would you be willing to receive any of your equity, if applicable, in the form of monthly payments? *			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? *			$

 

Comments
Your Comments	Do you have any questions or comments you would like to share with us?