ATTENTION PHONE REPS: THIS FORM MUST BE ENTIRELY COMPLETED ON ALL INCOMING CALLS!!  A representative will make a callback in 24-48 hours to discuss the details if we are interested in buying their house.

Name :
What is the address of the property you are selling?  :
City :
State :
Zip Code :
Phone :
Email - (type none@none.com if you dont have an e-mail address) :
What kind of house do you have for sale? :
Name of Development where home is located :
Why are you selling? :
What is the approximate 1st mortgage balance? :
Amount of 2nd Mortgage or Equity Mortgage - if any? :
What is/are the current mortgage payment(s)?  :
Is/Are the loan(s) behind in payments? :
If late, how many months? :
Does the house need repair?  :
What is the cost of the repairs? :
Please describe what repairs are needed  :
How many bedrooms and bathrooms? :
How long have you owned this house? :
Is the house vacant or occupied?  :
What are you asking for the house? :
What amount do you think it would appraise for?  :
How did you hear about us? :
Any additional information about the house or your situation :
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