Secure Application to Sell a House To Us



The only information we require on this form is your name and a way to contact you;
however, the more information you provide the better prepared we will be when we contact you.

Contact Information

  * First and Last Name:  
  * Address of Property for Sale:
  * City, State and Zip Code:
   E-mail Address:
   Daytime Phone with Area Code:
   Evening Phone with Area Code:
  Cell Phone with Area Code:
  * Are You The Owner?

  If "No", Please list the Owners Name:
   How Quickly Do You Need to Sell?
   Reason for Sale:

If "Other" please specify:
  Property Information
  * Property Type:
  * Property or Home Condition:
  * Estimated Value:
  How Much Would You Sell For If You Could Get a Fast "All Cash" Sale Now?
  Square Footage (if known):
  Number of Bedrooms:
  Number of Bathrooms:
  Age of Home:

   Is the Property Currently Occupied?

   Are You Living in the Property?

   Is the Property listed with a Realtor?

  Mortgage Information
  1st Mortgage Balance Estimate:
  Monthly Payment:
  Does first mortgage payment include: taxes and insurance?

  Are You Current On Payments?
  How Many Payments Are You Behind?
  Do You Have a 2nd Mortgage or Home Equity Loan?

  Are You Current On Payments?
  2nd Mortgage or Equity Loan Balance Estimate:

Other Notes or Comments
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