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Filling out this form and submitting it now is the quickest and easiest way to find out how we can help your family. We'll get back to you very soon to discuss our options!

 

 

Or, if you'd like more information before you tell us about your home, contact us by phone or e-mail and we'll get right back to you.

 

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Name*
Day Phone*

Evening Phone*

Email Address*
Street Address*
City*
State*
Zip Code*
Subdivision Name (if any)
How did you hear about us?
Tenants? yes no If yes, how long have they rented?
Do you have a lease? yes no If yes, expiration?  
How many payments did they make in the last 12 months?
What is the Monthly Rent being charged? ffffffff
What are the Monthly Management Fees? fffffff
What are the Monthly Utilities? fffffffffffffffffffffffffffff
What are the Other Monthly Costs? ffffffffffffffffffff
How much do you owe on your house?*
1st Mortgage
Balance*
1st Mortgage
Payment*
1st Mortgage Holder*
2nd Mortgage
Balance
2nd Mortgage
Payment
2nd Mortgage Holder
Do you have an equity line on this house?
Balance
Payment
Holder
So the total monthly payment is*
Are the payments current?
Yes No
If no, how far behind?
Is the house attached to a bankruptcy? Yes No
How much do you need now for your house?
What do you think your house is worth?
How did you arrive at that number?
Real Estate Agent 
Appraisals
Comparables
Tax Assessment
Guess
Does the house need repairs? yes no
If "yes," what kind?
Ranch 2-Story Split
Foyer
Split
Level
Sq. Footage
All
Brick
Brick
Siding
Wood
Siding
Vinyl
Siding
Stucco
Lot Size
# of Bedrooms # of
Baths
Formal
Living Rm
Formal
Dining Rm
Fireplace Ceiling
Fans
Fenced Pool Sewer
Septic
Crawl
Space
Slab Basement Finished Age of Roof
Unfinished
Garage Number
of Cars
Central
Air
Number
of Units
Carport
When was the house built?
How long have you owned the house?
Why are you selling?
Is it listed with an agent? yes no
If yes, when does the listing expire?

 

 

 

 

 

 

 

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Last Update:

08/21/2010 09:06:17 PM

 

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