Property Info Form

Contact Information

First Name: [field id="field_41ada14"]
Last Name: [field id="field_154ed7c"]
Address: [field id="field_8feae53"]
City: [field id="field_ac0bec7"]
State: [field id="field_52e670f"]
Zip Code: [field id="field_6dc2ed2"]

Telephone: [field id="field_739df81"]

Email: [field id="field_86a58e3"]

How soon do you want to move?: [field id="field_6cb54c6"]

Do you  consent to be contacted by Text, Voice, or Email? [field id="field_18822df"]

User Property's Information

Address: [field id="field_9e657f5"]
City: [field id="field_ae9c1a3"]
State: [field id="field_6b10b4c"]
Zip Code: [field id="field_dfe1634"]
Is your house listed with a Realtor?: [field id="field_28faaa4"]

If Yes at what price?: [field id="field_63e07d0"]

Is the house vacant or occupied?: [field id="field_fbac92a"]

Does your house need repairs?: [field id="field_7533b88"]

If Yes how much do you think these repairs would cost? : [field id="field_4602ae3"]

Users Sale And Loan Information

How much are you asking us to pay for your house? : [field id="field_706f4ff"]
How did you determine asking price? : [field id="field_2fd5d1b"]

Value: If you had your property appraised how much do you think it will be worth? : [field id="field_8b68ef6"]

1st Mortgage

Balance : [field id="field_4beb754"]
Monthly mortgage payment : [field id="field_2792892"]

Does this include insurance and taxes? : [field id="field_9175025"]

Interest Rate: [field id="field_5aac770"]

Payments behind? [field id="field_d6c1cf0"]

If yes how far behind? [field id="field_cc63b06"]

2nd Mortgage

Balance: [field id="field_0715d6c"]
Monthly mortgage payment: [field id="field_c318602"]
Interest rate: [field id="field_cc442bd"]
Does this include insurance and taxes?: [field id="field_1bf6f22"]
Payments behind?: [field id="field_3d9c27d"]
If Yes how far behind?: [field id="field_0665184"]
Would you be willing to sell your house by allowing us to take over the payments?: [field id="field_622a36f"]
Are you willing to accept some creative financing terms that will allow us to buy your house?: [field id="field_4dcb494"]
Would you be willing to sell your house for what you owe on it?: [field id="field_b3366af"]

Why are you selling?: [field id="field_48429b8"]

Alternatives to selling? [field id="field_98cd52c"]

How quickly do you need to sell?: [field id="field_2a5895a"]
Other Information or Comments?: [field id="field_ea52efd"]
How did you hear about us?: [field id="field_29f9863"]