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Sell your house - Tell Us About Your House For a Quick Sale

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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
 
Your Street Number
 
Your Street Name
Your Zip
 
Your City
 
Your State
* 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
Is the house currently listed
with a ®Realtor?
  Yes  No
If Yes, when does the listing expire?
  mm/dd/yyyy
How much do you think
these repairs will cost?
$  e.g. 5000 (not 5,000)  
Property Type
*Approx. Square Feet
 
*Year Built
*Bedrooms
*Bathrooms
Garage?
Yes  No 
Is it Vacant?
Yes  No 
Price And Terms
   1st Mortgage  2nd Mortgage
* Balance  $  $
 Monthly
Payment		  $ $ 
Interest Rate     %   %
Term of Loan in Years?    
Years Remaining on Loan?    
Adjustable
Mortgage?		    Fixed  Adj     Fixed  Adj 
Are Payments
Current?		   Yes  No   Yes  No
If Not How Far
Behind?		  $  $
Total Lien Amount
(if more than 1,
list each separately)?
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?
*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 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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