Seller Intake Form
Turning Dreams Into Addresses
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Are you Married?
*
Please Select
Yes
No
If Married, is there joint ownership?
*
Please Select
Yes
No
Spouse Name
First Name
Last Name
Spouse Email
example@example.com
Spouse Address (If Different from above)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Tell Me About Your Home
Do you live in the home?
*
Renters?
*
Please Select
Yes
No
If vacant, how long?
Have you been on the market before?
*
Please Select
Yes
No
If so when?
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Approximation
Reason for selling?
Specify Style of Home
Single occupancy house
Apartment/Loft
Flat
Ranch Style
Bungalow
Split Level
Duplex
Other
Number of Bedrooms
*
Number of Bathrooms
*
Fireplace?
*
Please Select
Yes
No
Garage?
*
Please Select
Yes
No
Garage Type
*
Please Select
Attached
Detached
Spaces?
*
Please Select
Yes
No
Basement
Full
Partial
Walkout
Finished
Unfinished
Crawl
Slab
Notes/Updates/Issues - Anything that impacts salability:
Submit
Should be Empty: