Home Buying, Home Selling, Home Repair

Contact Info
	Are You The Owner?
	Owner's Full Name:
	Day Phone:
	Evening Phone:
	Cell Phone:
	Best Time To Call:
	E-Mail Address:
	Property Address:
	City:
	State:
	Zip:

Mortgage Info
	1st Mortgage Balance: $
	Monthly Payment: $
	Interest Rate: %
	Does first mortgage payment include taxes and insurance?	Yes No
	2nd Mortgage Balance: $
	Monthly Payment: $
	Interest Rate: %
	Are the Payments Current?
	If Not, How far Behind are they?
	How did you hear about us?

Property Info
	Market Value:
	How Long Owned?
	Bedrooms:
	Bathrooms:
	Garage:
	Square Footage:
	Property occupied?
	Listed with Realtor?
	With quick close and immediate cash payment, what is the lowest offer you would accept? $
	How did you arrive at this price?
	Why are you selling?
	When do you want to Sell?
	Will You Allow Us to Take Over Your Payments?
	List any problems or repairs noticed:

	Estimated Repair Cost?