Address:

City:

State/Prov:

—Please choose an option—AlabamaAlaskaAlbertaAmerican SamoaArizonaArkansasBritish ColumbiaCaliforniaColoradoConnecticutDelawareDist of ColumbiaFed. St. of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineManitobaMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew BrunswickNew HampshireNew JerseyNew MexicoNew YorkNewfoundlandNorth CarolinaNorth DakotaNorthern Mariana IslandsNorthwest TerritoryNova ScotiaNunavutOhioOklahomaOntarioOregonPennsylvaniaPrince Edward IslandPuerto RicoQuebecRhode IslandSaskatchewanSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingYukon Territory

Zip/Postal Code:

County:

Name1:

Name2:

Address:

City:

Zip/Postal Code:

Home Phone:

Work Phone:

Mobile Phone:

E-mail Address:

Receive SMS Notifications:

Receive SMS Notifications:

Property Type:

—Please choose an option—Single Family,Mobile W/ landCondoTown HomeDuplexTriplexQuad5+ ApartmentMobile In ParkMobile W/ LandModularCommercialLandOther

Square Feet:

Year Built:

# Bedrooms:

—Please choose an option—12345678910+

# Bathrooms:

—Please choose an option—11.522.533.544.5515.5

# Stories:

—Please choose an option—11.52345678910+

Current value:

Value Method:

—Please choose an option—AppraisalRefinanceR/E AgentNeighborGuess

Are you in foreclosure?

YesNo

Date foreclosure was filed:

Auction Date:

Would you sell the property for what you owe?

YesNo

What would be the least you would accept if we could close within the next 7 days or a date of your preference?

Garage:

—Please choose an option—NoneDrivewayCarport1 Car2 Car3 Car4 Car5+ Car

Pool:

—Please choose an option—NoneAbove GroundIn GroundPool W/ JacuzziJacuzzi

Basement:

—Please choose an option—YesNoFinishedUnfinished

Occupant:

—Please choose an option—OwnerTenantVacant

Lot Size:

Waterfront:

—Please choose an option—NonePondLakeviewLakefrontLake & DockCanalCanal & DockOceanviewOceanfrontOcean & Dock

Property Listed:

—Please choose an option—Not Currently ListedFor Sale by OwnerListed w/Real Estate Agent

For How Long:

—Please choose an option—< 1 Month> 1 Month3 Month4 Month5 Month6 MonthExpired

List Price:

Condition:

—Please choose an option—TeardownPoorFairGoodExcellentBrand New

List Of Repairs:

Reason For Selling:

Ideal Close Date:

How Did You Hear About Us?

Lender:

Loan Balance:

Interest Rate:

Monthly Payment:

Age of Loan (Yrs):

Payments Current

Amount In Arrears:

HOA Fees:

Condo Assoc Fees:

Special Assessments:

Property Taxes:

Current Rent:

1sts Lien Name:

1sts Lien Amount:

2nd Lien Name:

2nd Lien Amount:

Lender:

Loan Balance:

Interest Rate:

Monthly Payment:

Age of Loan (Yrs):

Payments Current

Amount In Arrears:

Lender:

Loan Balance:

Interest Rate:

Monthly Payment:

Age of Loan (Yrs):

Payments Current

Amount In Arrears: