Real Estate Lead Intake Form

Are you looking to renovate your property?Complete this form and we will contact you about your options.
Contact Information
Full Name *

First Name Last Name
Phone Number *

Area Code Phone Number
Mobile Number *
Second Number *
Email *
example@example.com
Best Time to Call *

Property Information
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Bedrooms:
Bathrooms:
What is the approximate square footage:
Year Built:
How many stories?
Garage:
What is the current condition of your property?
What kind of repairs and maintenance does the house need?
How much do you think these repairs will cost in dollars? $
How long has the property been for sale?
Is the house currently listed with a ®Realtor?

Yes No
when does the listing expire?

Pricing Information
How much are you asking for your property?
What do you think your house is worth?
How did you determine the value?
When would you like to sell
Are there any Liens on the property?

Yes No
Are your property taxes current?

Yes No
Is the title free and clear?

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: