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Message to Realtors®
Property Information Form
To have your house considered for purchase,
please fill out the online form below and submit.
Or...Print the filled out form OR alternatively save the filled out form as a pdf.
and fax the completed form to 1-800-714-9409.
Thanks!
Personal Information
*
First name:
*
Last name:
*
E-mail address:
*
Daytime phone:
(Please include area code)
Evening phone:
(Please include area code)
Best time to call:
Property Information
*
Property street address:
*
Property City
*
Property State:
*
Property Zip:
The Property is currently:
Owner Occupied
Occupied by Renter
Vacant
Bedrooms:
1
2
3
4
5
6+
Baths:
1
1.5
2
2.5
3
3.5
4+
Square footage:
Age of House:
Garage:
Please Select
One Car Attached
One Car Detached
Two Car Attached
Two Car Detached
Three Car or More Attached
Three Car or More Detached
Carport
None
Other
What is the general condition of the house:
Please Choose
Excellent
Good
Fair
Poor
UGLY!
Please describe any needed repairs in this box
Property Interior Features
Please check all that apply:
Wood Floors
Formal Dining Room
Carpeting
Game Room
Tile
Fireplace
Finished Basement
Unfinished Basement
Property Exterior Features
Please check all that apply:
Swimming Pool
Deck
Privacy Fence
Other Fence
Brick
Vinyl Siding
Steel Siding
Wood Siding
Other Siding
Stucco
A/C, Heating, and Sewage
Please check all that apply:
Central Heat
Central Air
Floor Furnace
Wood Stove
Septic Tank
Additional Storage
Please check all that apply:
Crawl Space
Slab
Storage Shed
Shop
Mortgage Information
How much do you feel the property is worth:
1st mortgage balance:
1st mortgage payment amount:
Does the 1st mortgage payment include taxes and insurance:
Select
Yes
No
Are there other mortgages on the property:
Select
Yes
No
What is the combined balance of all mortgages:
What is the combined monthly payment on all mortgages:
Please tell us about any other liens and/or other title problems that may affect this property by typing an explanation here.
Can you sell for what you owe?:
Select
Yes
No
Are all mortgage payments current:
Select
Yes
No
If payments are not current, how far behind are they:
1st Mortgage
$ Amount behind
# of payments
2nd Mortgage
$ Amount behind
# of payments
Other Mortgage
$ Amount behind
# of payments
Have you received a foreclosure notice:
Select
Yes
No
Has a foreclosure sale date been set:
Select
Yes
No
Sale date:
Additional Information
Is your property currently listed
with a real estate agent/broker:
Select
Yes
No
If property "is" listed, when does your listing expire:
Are you currently in bankruptcy:
Please Select
No
Yes - Chapter 7
Yes - Chapter 13
*
How did you hear about us:
Referral from Flyer
Referral from Attorney
Referral from CPA
Referral from Friend
Referral from Realtor
Local Newspaper
Postcard
Letter
Sign
Internet search engine
Link from other Internet site
Other
Please provide any further comments that you feel are important in the box below...
Comments
