Confidential
*Only Completed Forms Will Be Considered
Name:
Email:
Daytime Phone Number:
Property Address:
Property Type:
Single Family Home
Duplex
Triplex
4-Plex
Mobile Home
Condo
Commercial Property
Other
Why Do You Need to Sell Your Property:
When Do You Need To Sell Your Property:
Type of Maintenance or Repairs Needed:
Balance 1st Mortgage:
Balance 2nd Mortgage:
Monthly Payment Amount:
Are Your Property Taxes and Insurance Included In Mortgage Payment:
Yes
No
Are You Behind On Payments:
Yes
No
If Behind on Payments How Many Months:
Amount of Any Additional Liens:
How Much Would Your House Appraise For:
Would You Sell Your House For What You Owe On It:
Yes
No
Undecided
Are You Willing To Receive Any of Your Equity In Monthly Payments:
Yes
No
Undecided
Willing to Sell By Letting Us Take Over Your Monthly Mortgage Payments:
Yes
No
Undecided
If We Could Buy Your House In The Next 10 Days What Is The Least You Could Accept: