Email Address*: 

Phone 1 (We'lll call this number first)*:

Phone 1 Type*: _______ Home Office Cell Fax Other

Phone 2: 

Phone 2 Type: _______ Home Office Cell Fax Other

Property Location Information:

Address*: 

City*: 

State*:    Zip*: 

Subdivision: 

Property Condition Information:

Listed with a Realtor?*:  _______ Yes No

Lot:  _______ Subdivision Lot Acreage   Acres (If on an acreage): 

Type of House: _______ Site-Built: Slab Foundation Site-Built: Pier and Beam Foundation Manufactured Home: Single-Wide Manufactured Home: Double-Wide Other

Square Feet:     Stories: 1 2 3 Multi-Level   

Bedrooms:    Bathrooms: 

Living Areas:    Dining Areas:   

Garage:  None 1-Car Detached 2-Car Detached 3-Car Detached 1-Car Attached 2-Car Attached 3-Car Attached Other   Pool:  None Above Ground Inground

Year Built:      Age of Roof:

Outbuildings (list all): 

Occupancy:  _______ Vacant Owner Occupied Rented Other   Monthly Rent (If Rented):    

When Does Current Lease End?

Condition:  _______ Move-in Condition Minor Repairs Needed Major Repairs Needed

Repairs Needed: 

Please Briefly Describe Why You are Looking to Sell Your House:

What Will You Do if it Doesn't Sell?: 

Property Financial Information:

1st Lien (Mortgage)

Amount Owed: 

Lien Holder (Mortgage Company): 

Payment: 

Includes Taxes and Insurance (Escrow)?:  _______ Yes No

Interest Rate: 

Loan Type: _______ FHA VA Conventional: Fixed Rate Conventional: Variable Rate (ARM) Home Improvement Loan Home Equity Line of Credit Other

Amount of Back-Payments Owed (Arrears): 

2nd Lien (Mortgage) 

Amount Owed: 

Lien Holder (Mortgage Company): 

Payment: 

Interest Rate: 

Loan Type: _______ FHA VA Conventional: Fixed Rate Conventional: Variable Rate (ARM) Home Improvement Loan Home Equity Line of Credit Other

Amount of Back-Payments Owed (Arrears): 

Additional Liens

Back Taxes Owed: 

IRS Liens Owed: 

Construction/Other Liens Owed: 

Are you Currently in Bankruptcy? _______ No Chapter 7 Chapter 11 Chapter 13 Other

Pricing:

Appraised Value: 

Source of the Appraisal Value?:  _______ Tax Record Formal Appraisal Done This Year Formal Appraisal Done Last Year Formal Appraisal Done Previous Years Realtor Quote Neighbor's Home Sale Best Guess Other

Current Asking Price: 

Minimum Price You Will Sell For: 

Will You Sell the House for what You Owe? _______ Yes No

Would You Consider Letting Us Take Over Your Payments? _______ Yes No

Would You Consider Taking Some Cash Now, Some Later? _______ Yes No

How much Cash would you need Right Now?

Marketing Research:

How Did You Find Us?:  _______ Reporter SA Express Mail Sign Craigslist Flyer Door Hanger Greensheet Ad Web Search Referral Other

Sign Location: 

Additional Information:

Please tell us any additional information you think will be useful in our evaluation:

CONFIDENTIAL!