Home Seller Form
Please fill out as much information as you can about your property so that we can evaluate which program might best suit your needs.
Contact Information
Full Name
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
Mobile Number
Format: (000) 000-0000.
E-mail
*
example@example.com
Best Time to Call
Please Select
Morning
Afternoon
Evening
How did you hear about us?
Property Information
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Bedrooms:
Please Select
1
2
3
4
5
6
7
8
9
10+
Bathrooms:
Please Select
1
2
3
4
5
6
7
8
9
10+
What is the approximate square footage:
Year Built:
How many stories?
Garage:
Please Select
None
1 car Attached
1 car Detached
1.5 Car Attached
1.5 Car Detached
2 Car Attached
2 Car Detached
2.5 Car Attached
2.5 Car Detached
3 Car Attached
3 Car Detached
3.5 Car Attached
3.5 Car Detached
Carport
Other
What is the current condition of your property?
Please Select
Excellent
Good
Fair
Poor
Terrible
How many years have you owned this home:
What kind of repairs and maintenance does the house need?
How much do you think these repairs will cost in dollars? $
Is there anyone living in the house?
Please Select
Yes-Owner Occupied
Yes-Tenant
No-Unoccupied
How long has the property been for sale?
Is the house currently listed with a Realtor®?
Yes
No
If No, has the house been previously listed?
Yes
No
If Yes, when does the listing expire?
Your Situation
What's your situation? Why are you selling?
Pricing Information
What do you think your house is worth? $
How much are you asking for your house? $
How did you determine the value?
Please Select
Appraisal
Realtor
Tax Assessment
Best Guess
Comparable
What is the least you would accept if we closed quickly?
Are you looking to sell your house for what you owe?
Yes
No
Maybe
How soon are you planning on moving?
Balance:
What is the balance on your first mortgage?
What is the balance on your second mortgage?
Interest Rate %
What is your current interest rate percentage on first mortgage?
What is your current interest rate percentage on second mortgage?
Payment:
Type a question
What is your first mortgage interest rate?
Fixed
Adj
What is your second mortgage interest rate?
Fixed
Adj
Payments Current?
Yes
No
If No, how far behind? $
Are your property taxes and insurance included in your monthly mortgage payment?
Yes
No
Do you pay Homeowner/Condo Association dues? If so, how much per year? $
How did you hear about us?
Do you have any questions or comments you would like to share with us?
Should be Empty: