First Name

Last Name

Email address

Address

Home phone number

Cell phone number

1. Is your property already on the market? Is it listed with an agent? Yes No

If yes When was it listed on the market? Who is the listing agent?

2. When was the property purchase?

3. Original purchase price?

4. Who is on title?

5. Who is on the mortgage?

6. What kind of mortgage do you have (Conventional, FHA, VA etc) and how many do you have? What kind: How many do you have:

Mortgage 1 Who is it with: Balance: Payment: Annual property tax: Annual H/O INS: HOA:

Mortgage 2 Who is it with: Balance: Payment:

7. Are you living in the property? If not where are you living and is the property being maintained?

8. What is the condition of the property? What repairs are needed? Good condition just cosmetic repairs

9. If you are relocating when do you have to move?

10. Are you up to date on your condo or Home Owners Association payments? Yes No

If not how many months are you behind? Contact info:

11. Do you owe back taxes? Are there any other liens on the property?

12. Have you considered or are you considering declaring bankruptcy? Yes No

13. Are you current on all your mortgage payments and will you be able to remain current?

14. What is the situation that caused you to miss your payments (if not late) why do you want to sell?

15. What is your household monthly income after taxes?

16. What are your estimated monthly expenses besides the mortgage?

17. Do you hold any security clearance?

18. Comments

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