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
Evening
Phone Number
Your
Cell Phone
Your
Street Number
* Your
Street Name
Your
Zip
Your
City
Your
State
...
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Guam
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Virgin Islands
Vermont
Washington
Wisconsin
West Virginia
Wyoming
* What's your situation?
Why are you selling?
When
do you need to sell your house?
Property Information
Same
as my home address above
* Street
Number
* Street
Name
* Zip
* City
* State
...
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Guam
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Virgin Islands
Vermont
Washington
Wisconsin
West Virginia
Wyoming
* Is
the house currently listed
with a ®Realtor?
Yes
No
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
Single
Family House
Duplex
TriPlex
4-Plex
Multi-Family
Commercial
Property
Land
Other
Multiple
/ Combo
Townhome
Condo
Patio
Home
Approx.
Square Feet
Year Built
Bedrooms
Bathrooms
Garage?
Yes
No
Is
it Vacant?
Yes
No
Style?
Ranch
Split-Level
Post-Modern
Office Condo
Retail Strip Center
Office Building
Number of Stories (without basement)?
1 Floor
2 Floors
3 Floors
Is there a basement?
Yes
Unfinished
Partially Finished
Fully Finished
Exterior Wall Finish?
All Brick
Siding & Brick/Stone
All Siding
Stucco
Other
Price
And Terms
Total Lien Amount
(if more than 1,
list each separately)?
How
much are
your total annual
property taxes?
$
e.g. 5000 (not 5,000)
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?
$
e.g. 5000 (not 5,000)
How
much are you asking
us to pay for your house?
$
e.g. 5000 (not 5,000)
How
did you determine
your asking price?
Appraisal
Realtor
Tax
Assessment
Best
Guess
Comparables
Amount
Needed to Move
* 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
* 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?
$
e.g. 5000 (not 5,000)
How
did you hear about us?
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O N F I D E N T I A L