Pre-Listing Questionnaire

Your Name(s) as on Title

Address

Street Address

CityState / Province

Postal / Zip Code

Phone Number

Format: (000) 000-0000.

E-mail

example@example.com

Are you working with another real estate agent? If so, who?

NamePhone NumberEmail Address

Fee Simple / Ground Rent / (if you don't have ground rent, most likely fee simple)

Preferred List Price

Who do you pay your mortgage to? Is there a second, or home equity?*

What are the payoff amounts as of this month? Rounded to thousand is okay.

e.g., 23

Additional inclusions and/or Notes from Inclusions above:

What items are included in the sale of the property?

Any Specific Exclusions

Any leased items (please specify and explain, e.g. solar panels, fuel tanks, etc):

Electronics (please specify and explain any and all electronics currently present in your house, for example: smart thermostat, alarm system, ring doorbell, keypads, etc.) For every item, please specify whether or not it will be left and if so, how it works.

What year was your home built?

Age of Roof?

Age of HVAC?

Last HVAC Servicing?

Any improvements made to the home in the last 4 years?

Water Supply

Sewage Disposal

Heating

Hot Water

Air Conditioning

Is there anything wrong with the house? Any hidden defects, such as, but not limited to leaking pipes, roof, electric issues, or anything not readily seen? This does not include items you’ve already repaired. If yes, please list, if no, write “none”

Does your property have a DEFERRED WATER fee that has been established by recorded covenant or declaration? This is typically for newer communities that a once a year fee that covers the initial installation or we are fresh and sewer, water lines. (this is not your water bill) please ask your agent for more clarification. And/if so please take the amount.

Deferred Water Amount

Is your property within 1 mile of a Superfund Cleanup site? https://map22.epa.gov/cimc/superfund

Is your property subject to a conservation easement or any other restriction limiting or affecting use of the property?

If there is Ground Rent on this property, please give details: Total Amount Yearly, Name, Address, and Phone of whom it is paid.

Utility Providers

Rows	Not Satisfied
Electric
Gas
Water
Oil

Trash

Recycling

Home Security System (ADT, Nest, Ring, Doorbell, Etc.)

Garage Code:

If you have an HOA or Condo Association, please keep goi, otherwise scroll to the bottom and click SUBMIT.

Name of Association

Amount Paid…and…How Often?

Total Amount Paid Previous Calendar Year

Name, Address, and Telephone # of Management Company. (All 3 please)

Any Claims against Association that you are aware of?

What amenities are included with yours Association Fee? (e.g. water, grass, etc.)

Does the Homeowner’s Association have keys or fobs for access to any HOA common areas? Pools, Gym, or other facilities?

Anything related to the HOA/CONDO Association not already covered, please explain.

Thank you for taking the time to complete this form and thank you for helping me make this a smooth transaction. Once I receive this back I can complete and send the full agreement for your review and e-signature. If you have any questions at all, please give me a call at 443-621-0054.

Thank you again, Myra Chapman