Real Estate Lead Intake Form

Are you looking to sell your property?

Complete this form and we will contact you about your options.
Contact Information
Full Name*

First NameLast Name
Phone Number

Area CodePhone Number
Mobile Number*
Format: (000) 000-0000.
Second Number
Format: (000) 000-0000.
E-mail*
Best Time to Call
Property Information
Address

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?
How much do you think these repairs will cost in dollars? $
How long has the property been for sale?
IF NOT LISTED RESPOND WITH NOT
YesNo
Is there anyone living in the house?
YesNo
If Yes, when does the listing expire?
Why are you selling?
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
YesNo
YesNo
YesNo
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:

Contact Information