| Tell us about your... |
| * Your First Name:
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| * Your Last Name:
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| E-mail Address:
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Day Time Phone:
(Please include area code)
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Evening Phone:
(Please include area code)
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| Best Time To Call:
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| Tell us about the property... |
| Property Street Address:
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| Property City:
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| Property State:
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| Property Zip:
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| The Property is currently:
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| No. of Bedrooms:
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| No. of Baths:
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| Square Footage:
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| Age of House:
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| Garage:
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| What is the general condition of the house:
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| Please describe any needed repairs in this box:
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| For enclosure Information |
| Have you received a foreclosure notice:
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| Has a foreclosure sale date been set:
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| Sale Date |
(Please click on the calendar icon to select the date) |
| Tell us about the numbers... |
| How much do you feel the property is worth:
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| 1st mortgage balance:
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| 1st mortgage payment amount:
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| Does the 1st mortgage payment include taxes and insurance:
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| Are there other mortgages on the property:
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| What is the combined balance of all mortgages:
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| What is the combined monthly payment on all mortgages:
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| Please tell us about any other liens and/or other title problems that may affect this property by typing an explanation here:
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| Are all mortgage payments current:
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| If payments are not current, how far behind are they... |
| 1st mortgage |
| $ Amount Behind:
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| # of payments:
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| 2nd mortgage |
| $ Amount Behind:
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| # of payments:
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| Other mortgage |
| $ Amount Behind:
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| # of payments:
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| Just a couple more questions... |
| Is your property currently listed with a real estate agent/broker
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| If property is listed when does your listing expire:
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| Are you currently in bankruptcy:
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| How did you hear about us:
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| Please provide any further comments that you feel are important in the box below:
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