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We would appreciate your filling out as much information as possible, below.

Personal Information:

Your name :
Email :
Daytime phone (include areacode) :
Evening phone (include areacode) :
Best time to call :
How did you hear about us? :
Name of the above person, location, web site or search engine :
When do you want (or need) to move? :
Why are you selling? :

Property Information:

Do you own this property or have power of attorney? :
How long have you owned this property? :
Property street address :
Property city, state and zip :
Township, borough or municipality :
Property status :
Number of bedrooms :
Number of bathrooms :
What is the approximate square footage? :
What is the approximate lot size :
What is approximate age of house?  :
Parking :
Garage location :
General condition of the house :
Major repairs needed (check all that apply) : Roof
Exterior paint
Interior paint
Carpeting
Refinish floors
Windows
Furnace
Hot Water Tank
Kitchen
Bathroom(s)
Basement
Please describe what repairs are needed  :
In your opinion, how much would it cost to put your house into excellent condition? :
What do you think your house would appraise for (as is)?  :
How did you determine the above price? :
If we can offer you quick cash and close quickly, what would be the least you would take?  :
Are you willing to sell your house for what you owe on it? :

Rental Information (for rental units only):

How many units are there? :
Fully rented, how much do all units rent for per month? :
Which utilities are renters responsible for? :
Total monthly costs owner is responsible for :

Interior Features:

Floors (check all that apply) : Hardwood
Ceramic Tile
Carpeting
Linoleum
Additional rooms (check all that apply) : Living Room
Dining Room
Game Room
Den/Office
Finished Basement
Unfinished Basement
Fireplaces :
Other extras not noted :

Exterior features:

House style :
Exterior finishes (check all that apply) : Brick
Aluminum siding
Vinyl siding
Stucco
Block
Wood/frame
Faux brick
Roofing materials (check all that apply) : Slate
Asphalt shingle
Metal
Other
Extras (check all that apply) : In ground pool
Above ground pool
Deck
Covered porch
Privacy fence
Other extras not noted :

House Systems:

Comfort (check all that apply) : Furnace
Central air
Wood burning stove
Humidifier
Heat pump
Radiators
Baseboard (hot water)
Baseboard (electric)
Window A/C units
Oil
Approximate age of furnace/boiler :
Sewage :
Water :
Storage (check all that apply) : Crawl space
Attic
Shed
Workshop

Finance:

Are you currently in bankruptcy :
Have you received a notice of foreclosure? :
If you've received a foreclosure date, please enter it here :
First Mortgage
Lender name :
Balance :
Is this mortgage assumable? :
Interest rate :
Rate Type :
Monthly payment  :
Does the above amount include taxes and insurance? :
Is this mortgage current? :
How much are you behind? :
How many months are you behind? :
Second Mortgage
Lender name :
Balance :
Is this mortgage assumable? :
Interest rate :
Rate Type :
Monthly payment :
Is this mortgage current? :
How much are you behind? :
How many months are you behind? :
Insurance, taxes and other liens
Yearly insurance :
Do you have additional mortgages on this property? :
If there are additional liens, mortgages, or title issues please tell us about them :
Yearly school taxes :
Yearly local taxes :
Yearly county taxes :
Are your taxes current? :
---> How much are you behind on your taxes? :
---> How many months are you behind on your taxes? :

Other Information:

How long have you been trying to sell? :
Do you (or did you) have your house listed with a broker or realtor? :
---> When does the listing expire? :
Please provide any additional information that you believe might be helpful :
 
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