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Tell us about you
Your Name : *
Email Address : *
Daytime Phone :
Evening phone :
Best time to call :

Tell us about the property
Address : *
Address (Cont.) :
State : *
City :
ZIP Code : *
The Property is currently :
Bedrooms :
Baths :
Square footage :
Age of House :
Garage :
What is the general condition of the house :

Check all that apply
Wood Floors Carpeting Formal Dining Room
Game Room Tile Fireplace
Finished Basement Swimming Pool Privacy Fence
Other Fence

Tell us about the numbers
How much do you feel the property is worth :
1st mortgage balance :
1st mortgage payment amount :
Does the 1st mortgage payment include taxes and insurance :
Are there other mortgages on the property :
What is the combined balance of all mortgages :
What is the combined monthly payment on all mortgages :
Are all mortgage payments current :

If payments are not current, how far behind are they
1st mortgage:
$ Amount behind # of payments
2nd mortgage:
$ Amount behind # of payments
Other mortgage:
$ Amount behind # of payments
Have you received a foreclosure notice :
Has a foreclosure sale date been set :
Sale date :

Just a couple more questions
Is your property currently listed with a real estate agent/broker :
If property "is" listed, when does your listing expire :
Are you currently in bankruptcy :
How did you hear about us : *
Please provide any further comments that you feel are important in the box below