Please identify yourself:

First Name
Last Name
Middle Initial
Street Address
City
State
Zip Code
Best Place to Contact You	The Best Place To Contact Me At Is ... Cellular Phone E-Mail Address Fax Number Home Phone Other (comments) Work Phone
Work Phone
Home Phone
FAX
Cellular Phone
E-mail

Please describe the property:

Property Address		City
State		Home Condition	Home's Condition Excellent Above Average Average Below Average Fixer Upper Condemned
Style of Home	Home Style Ranch Bi-Level Tri-Level Quad-Level 1 1/2 Story Two Story Mobile/Modular	Type of Property	Type of Property Single Family Home Duplex Triplex Fourplex Multi-Family Mobile Home Modular Home
Property Occupied	Occupied Yes Vacant Tenants See Comments	Size of Lot	N/A Small Lot Normal Lot Large Lot 1/2 Acre Lot 1 Acre Lot 1-5 Acres 5-10 Acres 10+ Acres
# of Bedrooms	Bedrooms Above Grade Studio 1 2 3 4 5+	Fencing	None Some Chainlink Wrought Iron Wood Privacy See Comments
Total of Bedrooms	Bedrooms Including Bsmt. Studio 1 2 3 4 5+	Heating	N/A Forced Air Base Board Heat Wall Unit Wood Stove Other (see comments)
# of Bathrooms	1 1 1/2 2 2 1/2 3 3 1/2 4+	Age of Heating	New Less Than 1 Year 1 to 3 Years 3 to 5 Years 5 to 10 Years 10 to 15 Years 15+ Years
# of garages	None Carport 1 2 3 4+ 5+	Air Conditioning	N/A None Central Air Window Units
Attached/Detached	N/A Attached Detached Both	Age of Air Cond.	New Less Than 1 Year 1 to 3 Years 3 to 5 Years 5 to 10 Years 10 to 15 Years 15+ Years
Basement	Yes Partial Cellar Storm Shelter Crawl Space Slab View Out Walk Out	Roofing	Unknown Composition Wood Shake Roll Roofing Metal Tile See Comments
Basement Finished	N/A No Partly Yes	Age of Roofing	None Carport 1 2 3 4+ 5+
Other Features or Items About The Property?

Just A Few More Questions:

Does Anyone Else Own The Property With You?	Other Owners No Yes, my spouse Yes, other family Yes, other partners
How Long Have You Owned The Property?	Length You've Owned Less Than 1 Year 1 to 2 Years 2 to 3 Years 3 to 5 Years 5 to 10 Years 10 to 15 Years More Than 15 Years
How Quick Do You Want To Sell?	When You Want To Sell Yesterday This Week Within 1 Month 1 to 2 Months 2 to 3 Months 3 or more Months
Are You Ready To Sell The Property?	Ready to Sell Yes No Within 1 Month 1 to 2 Months 2 to 3 Months 3 or more Months
Amount of Cash You Will Take for The Property?