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No Obligation, Confidential Offer to Buy Your Home

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First Name*
First Name*

Last Name*
Last Name*

E-mail Address*
E-mail Address*

Street Address*
Street Address*

City*
City*

Zip/Postal Code*
Zip/Postal Code*

Daytime Phone*
Daytime Phone*

Are there any outstanding Loans?*
Are there any outstanding Loans?*

	Yes
	No

What is the balance?

Is/Are the loan(s) current?*
Is/Are the loan(s) current?*

	Yes
	No

What is your mortgage payment?

Homeowner Association Dues per year?

If I offered you Cash and closed quickly, what would be the least you would take?*
If I offered you Cash and closed quickly, what would be the least you would take?*

Does the house need repairs?*
Does the house need repairs?*

	Yes
	No

If Yes, how much?

How many bedrooms and bathrooms?*
How many bedrooms and bathrooms?*

What is the approximate square footage?*
What is the approximate square footage?*

Is the house occupied or vacant?*
Is the house occupied or vacant?*

	Occupied
	Vacant

If I had the house appraised, what would it appraise for?*
If I had the house appraised, what would it appraise for?*

Why are you selling?*
Why are you selling?*

How did you hear about us?

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