Seller Intake Form

Roshemia Peterson, P.A. Realtor

Thank you for your consideration in choosing me to help you sell your home! As your Realtor, you'll be offered top priority service, professionalism and elite guidance that will help direct you on making the best decision for your needs. By completing this form you will provide me insight on how I can best assist you in selling your home. Thank you again and I look forward to servicing you!
Full Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Date of Birth *

MonthDayYear
Date
Email
example@example.com
Best time to call*

MorningAfternoonEvening
Property Details*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Property Type*

Single FamilyTownhouse (legally)CondoVillaOther
Number of Bedrooms*
Number of Bathrooms*
What is the approximate square footage?*
Year Built
How many stories?
Garage:*

YesNo
If yes,

1 car garage Attached1 car garage Detached2 Car Garage Attached2 Car Garage Detached
Car Port:*

YesNo
What is the current condition of the home?

ExcellentGoodFairPoorTerrible
How long have you owned this property?
Select any appliances that will come with the home: *

RefrigeratorWasherDryerDishwasherMicrowaveOther
If other is chosen, name the appliances that will come with the home*
What repairs or maintenance is needed at the moment?
How much do you project these repairs to cost you?
Is there anyone living in the property?*

Yes, I amYes, Tenant occupiedNo property is vacant
Are there any Association fees?*

YesNo
If Yes, how much?*
How long have this property been for sale?
Is the property currently listed under another realtor?

YesNo
If No, has the house been previously listed?

YesNo
If Yes, when does the listing expire?
Your Situation
What's your reason for wanting to sell?
Are you looking to purchase another property once you sell?
Are you looking to purchase another property once you sell?

YesNo
If Yes, will your purchase be contingent on the sell of this property?

YesNo
Financials & Pricing
What do you think this home is worth?
How much are you expecting for your home?
What is the LEAST you would accept with a quick closing?
How did you determine the value?

AppraiserRealtorTax AssessmentBest GuessComparables
Are you looking to sell your home for what you owe?

YesNoMaybe
Existing Mortgage Information

(Required)
First Mortgage Balance*
Lender's Name*
Second Mortgage Balance *
Lender's Name*
Interest Rate
Monthly Payment
Do you pay Homeowner/Condo Association dues? How much? How often paid?
Are monthly payments current?*

YesNo
Amount behind (if any?)*
Did you receive any grant funds to purchase this property?

YesNo
If Yes, Please explain ( What City and Restrictions)
If we paid cash and closed by next Friday, what is the lowest amount you would be willing to accept?
Is the property CURRENTLY listed with a realtor?*

YesNo
Please share all vital information about you and your property below.
How did you hear about me?

FacebookInstagramReferralOther (Please Specify)
Referral Source/Name
Thank you for contacting Roshemia Peterson, P.A. Realtor

I look forward to assisting you in selling your property. I ask that you allow me to be the real esate professional that I am in servicing you in order to get your property prepped, on the market, and SOLD.
Should be Empty:

Roshemia Peterson, P.A. Realtor

Your Situation

Financials & Pricing

Existing Mortgage Information