Personal Information

 How  Did You Find Us?

Choose One Internet Search Craigslist Post Card in Mail Letter in Mail Friend  

 First Name

 Middle Name

 Last Name

 Email

 Confirm Email

 Home Phone

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 Cell Phone

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 Property Address

 City

 State

NC  

 Zip

 Sub Division Name

 Mailing Address (If different than
 Property address)

 Property Information

 Property Status

Choose One Pre-foreclosure Bankruptcy Own it and like to sell  

 Living Status

Choose One I live in the house Tenant live Vacant  

 Property Type

Choose One Single Family Single Family 2 Story Ranch 1 Story Town Home Condo  

 Built Year

 Square Foot

 Lot Size (Acre)

 Central Heat/Air?

Yes   No

 Bed Rooms

Choose One 1 2 3 4 5 6+  

 Bath Rooms

Choose One 1 1.5 2 2.5 3 3.5 4+  

 Garage

Choose One No Garage One Car Garage Two Car Garage Car Port  

 Living Room?

Yes   No

 Family Room?

Yes   No

 Screen Room?

Yes   No

 Deck?

Yes   No

 Patio?

Yes   No

 Fence?

Yes   No

 Stove is Present?

Yes   No

 Refrigerator is Present?

Yes   No

 Cost of Repairs ($)?

 Details of Repair?

 Why Selling?

 Any Liens or Judgments against the
 Property?

Yes   No

 How much are the Liens ($)?

 Do you have a recent Written
 Appraisal?

Yes   No

 How much is the Appraisal Amount
 ($)?

 Is House currently listed with a
 Realtor?

Yes   No

 Have you had any Written Offers
 yet?

Yes   No

 Mortgage Information

 Type of Loan

Choose One Conventional FHA VA Other  

 How many Months behind on your
 Loan Payments?

Choose One Zero Month One Month Two Months Three Months Four Months Five Months Six Months  

 First Mortgage Monthly Payment ($)

 Second Mortgage (if any) Monthly
 Payment ($)?

 Is your total remaining Loan and
 Liens are higher than the House
 Present Market Value?

Yes   No

 How much would you Sell to get
 Quick Cash ($)?

 How Quickly do you need to Sell?

Choose One 1 Week 2 Weeks 3 Weeks 4 Weeks 5 Weeks 6 Weeks 7 Weeks 8 Weeks  

 Please let us know how we can help