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Contact Information
Full Name
*
Full Name
First Name
First Name
Last Name
Last Name
Phone
*
Mobile or Home
Email
*
Preferred Contact Method
*
Phone
Email
Best Time To Call?
Morning
Afternoon
Evening
Property Information
Address
Address
Street Address
Street Address
Street Address Line 2
Street Address Line 2
City
City
State/Province
Alabama
Alaska
Arkansas
Arizona
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State/Province
Zip/Postal
Zip/Postal
Bedrooms
*
1
2
3
4
5
6
7
8
9+
Bathrooms
1
2
3
4
5
6
7
8
9+
Square Footage
*
What is the approximate square footage?
Year Built
*
How many stories?
*
1
2
3
4
Garage
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
Property Condition?
Excellent
Good
Fair
Poor
Terrible
What is the current condition of property?
Years Owned?
50
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?
50500
Is the home Occupied?
Please Select
Yes-Owner Occupied
Yes-Tenant Occupied
No-Unoccupied
Is there anyone living in the house?
Time on market?
Please Select
Less than 6 months
6 months to a year
More than a year
How long has the property been for sale?
Is the house listed with a Realtor?
Yes
No
Has the house been previously listed?
Yes
No
When does the listing expire?
Pricing Information
How much are you asking for your house?
How did you determine the value?
Please Select
Appraisal
Realtor
Tax Assessment
Comparable
Best Guess
What is the least you would accept if we closed quickly?
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