Real Estate Lead Intake Form

See a vacant property?

Complete this form and we will contact you if we can buy it. Get paid a referral fee even if you don't own it.
Contact Information
Full Name

First NameLast Name
Contact Number
Format: (000) 000-0000.
Second Number
Format: (000) 000-0000.
E-mail
Best Time to Call
Property Information
Address of property

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
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?
Is the house currently listed with a ®Realtor?
If Yes, when does the listing expire?
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?
Are your property taxes current?
Is the title free and clear?
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?
Do you have any questions or comments you would like to share with us?
Should be Empty:

Contact Information