Your name:
Email address:
Company name:
Phone Number:
Fax:
Best time to call:

Property Address:
City:
State:
Bedrooms:	Choose one 1 2 3 4 5
Bathrooms:	Choose one 1 1.5 2 2.5 3 +
Garage:	Choose one 1 2 3 4+

Square Feet:
Year Built:

Major Repairs needed?
Recent additions-repairs made? (ie: new roof 2004, new carpet 2003, etc)

Check all pertaining to property:	Wood Floors Game Room Patio/deck Formal Dining Room Central Heat Fenced in Yard Carpet Tile Study Fireplace Pool Central Air Other buildings on property
Foundation type:	Choose one Pier and Beam Slab

Current Value of home (in your estimation):
Mortgage on Property?	Choose one yes no

If yes, how much is still due on overall mortgage?
Are taxes & insurance included in monthly payments?	Choose one yes no

If no, how much are annual taxes & insurance?
Are all mortgage payments current?	Choose one yes no

If no, how much money is past due?
How far behind are payments? (ie: number of payments due)	Choose one 1 2 3 4+

Have you received a foreclosure notice?	Choose one yes no
If yes, what is the foreclosure sale date?

If we were to purchase your property and close quickly, what is least you could accept?

 

Any comments?