Your Contact Information

*Name      

Email         

*Day Phone    

Evening Phone

Your Situation

Why are you selling?

How soon do you need to move? And Why?

Your Property Information

*Address 

*City           *State  *Zip 

*Does your house need repairs? Yes No

If Yes, how much do you think the repairs will cost?

Is the house currently listed with a Realtor?  Yes No

If Yes, listed at what price?

Your Sale & Loan Information

How much are you asking us to pay for your house? 

How did you determine your asking price? Appraisal Realtor Tax Assessment Best Guess Comparables

If you were to have your house appraised, how much do you think it would be worth?

1st Mortgage                            2nd Mortgage or Home Equity Line of Credit

Balance             Balance

Payment            Payment

Interest Rate     Interest Rate

Lender              Lender

Payments Behind? Yes No          If Yes, amount behind? $

Are property taxes and insurance included in your monthly 1st mortgage payment? Yes No

Would you sell your house for what you owe on it?  Yes No Undecided

Would you be wiling to receive any of your equity, if applicable, in the form of monthly payments? 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? $

How did you hear about us?