* First Name:

* Last Name:

* The best phone number to reach you:

Alternate Phone:

Email Address:

* Address of the property you want to sell:

* City:

* State:

* Zip code:

Your mailing address (if different):

* Is the property currently listed with a realtor?

* Is this a mobile home?

* Number of bedrooms:

* Number of bathrooms:

Your best estimate of the square footage:

Is the house vacant, owner-occupied, or does it currently have a tenant?

Would you say the condition of the house is excellent-move-in-ready, needs minor repairs, or needs major repairs?

Please list repairs/updates needed to make the house ready for sale on the market (to make it pretty):

Please describe the situation that is causing you to want to sell your house. How can we help you?:

What will you do if we can't find a way to help you?

What is your best estimate of the TOTAL amount of all mortgages and other liens against this property?

If you are behind on any of the mortgage payments or taxes, please tell us your best estimate of the amount that you are behind:

What do you think your house is worth?

If we pay CASH, close quickly, and take the property in as-is condition, what is the LEAST you will take?

Will you take what you owe?

Would you consider letting us take over your payments?

* Finally, How did you hear about us?

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