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Tell us about you
Your Name :
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Email Address :
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Daytime Phone :
Evening phone :
Best time to call :
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Daytime
Evening
Tell us about the property
Address :
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Address (Cont.) :
State :
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District of Columbia
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West Virginia
Wisconsin
Wyoming
Alabama
Alaska
Arizona
Arkansas
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
*
City :
ZIP Code :
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The Property is currently :
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Owner Occupied
Abandon
Bedrooms :
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1
2
3
4
5
6
7
8
9
Baths :
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1
2
3
4
5
6
7
8
9
Square footage :
Age of House :
Garage :
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Yes
No
What is the general condition of the house :
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Excellent
Good
Needs Some Work
Fixer upper
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 :
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Yes
No
Are there other mortgages on the property :
Select
Yes
No
What is the combined balance of all mortgages :
What is the combined monthly payment on all mortgages :
Are all mortgage payments current :
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Yes
No
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 :
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Yes
No
Has a foreclosure sale date been set :
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Yes
No
Sale date :
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Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
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Just a couple more questions
Is your property currently listed with a real estate agent/broker :
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Yes
No
If property "is" listed, when does your listing expire :
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Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
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1
2
3
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Are you currently in bankruptcy :
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Yes
No
How did you hear about us :
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From Friends
From Newspaper
From Website
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Please provide any further comments that you feel are important in the box below