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Contact's Full Name
*
First Name
Last Name
Contact's Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
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Vatican City
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Vietnam
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Isle of Man
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Wallis and Futuna
Western Sahara
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Other
Country
Contact's Phone Number
*
-
Area Code
Phone Number
Are you the:
*
Agent/Realtor
Home Owner
Existing Mortgage Information
(Required)
1st Mortgage $
*
Lender Name
APR %
Monthly Pymt
*
Is there a 2nd Mortgage?
*
Yes
No
2nd Mortgage $
Lender Name
APR %
Monthly Pymt
*
Does payment include PITI? (Principal, Interest, Taxes & Insurance)
*
Yes
No
Are monthly payments current?
*
Yes
No
Amount behind (if any)?
If we can agree upon a price and we accept all responsibility for future repairs would you, or the owner, consider a lease purchase?
*
Yes
No
Undecided
If the asking price and the loan balance are within $35,000 of each other would you, or the owner, sell the house for the amount you owe on it?
*
Yes
No
Undecided
If the home is paid for in full, or almost paid for, would you, or the owner, consider taking monthly payments for your equity?
*
Yes
No
Undecided
What is it that you need to have from the sale of your home?
*
Need immediate payoff before losing the property.
Take over payments because can't afford two house payments.
No immediate concerns so I would be OK with accepting pre-determined payments for a specified length of time.
Other
Please select the best day(s) of the week with when to contact you:
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Please select the best time slot(s) which would be best to contact you:
*
8:00am - 10:00am
10:00am - 12:00pm
12:00pm - 2:00pm
2:00pm - 4:00pm
4:00pm - 6:00pm
Asking Price
*
Owner's Estimated Value
*
How did you arrive at your asking price?
*
Amount left on mortgage
Real Estate Agent recommended
Comparable home sales
Equal to amount of equity
Other
If Other, please explain:
Reason for selling?
Are any repairs needed?
*
Yes
No
If Yes, please explain:
If you currently reside in the residence, when would you want to move?
Is the property CURRENTLY listed with any realtor/agent?
*
Yes
No
If Yes, then how long has the property been listed?
Property Information
Property 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
Number of bedrooms:
*
Please Select
Studio
1
2
3
4
5+
Number of bathrooms:
*
Please Select
1
1-1/2
2
2-1/2
3
3-1/2
4+
Lot size:
*
Type of construction:
*
Please Select
Block
Brick
Frame
Stucco
Other
If Other, please explain:
Garage:
*
Please Select
0
1
2
3
Carport:
Yes
No
Basement:
*
Yes
No
If Yes, is the basement finished or unfinished?
Please Select
Finished
Unfinished
Select any appliances that will come with the home:
*
Refrigerator
Range
Microwave
Dishwaher
Washer
Dryer
Is the property:
*
Vacant
Occupied
Is the property a condo?
*
Yes
No
Any Association fees?
*
Yes
No
If Yes, how much?
Please add any additional comments you feel are important about the property that were not covered above:
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