Contact Information Contact's Full Name* First NameLast Name Contact's Phone Number* -Area CodePhone Number Email example@example.com Are you the:* Agent/RealtorHome Owner What is it that you need to have from the sale of your home?* Need immediate payoff before losing the property.Take over payments because can't afford two house payments.No immediate concerns so I would be OK with accepting pre-determined payments for a specified length of time. Please select the best day(s) of the week with when to contact you:* MondayTuesdayWednesdayThursdayFridaySaturday Please select the best time slot(s) which would be best to contact you:* 8:00am - 10:00am10:00am - 12:00pm12:00pm - 2:00pm2:00pm - 4:00pm4:00pm - 6:00pm Asking Price* Owner's Estimated Value* How did you arrive at your asking price?* Amount left on mortgageReal Estate Agent recommendedComparable home salesEqual to amount of equityOther If Other, please explain: Reason for selling? Are any repairs needed?* YesNo If Yes, please explain: If you currently reside in the residence, when would you want to move? Is the property CURRENTLY listed with any realtor/agent?* YesNo If Yes, then how long has the property been listed? Property Address* Street Address Street Address Line 2 CityState / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Nagorno-Karabakh Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Turkish Republic of Northern Cyprus Northern Mariana Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Republic of the Congo Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia South Sudan Spain Sri Lanka Sudan Suriname Svalbard eSwatini Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Transnistria Pridnestrovie Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands Isle of Man US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Number of bedrooms:* Please Select Studio 1 2 3 4 5+ Number of bathrooms:* Please Select 1 1-1/2 2 2-1/2 3 3-1/2 4+ Lot size:* Type of construction:* Please Select Block Brick Frame Stucco Other If Other, please explain: Garage:* Please Select 0 1 2 3 Carport: YesNo Basement:* YesNo If Yes, is the basement finished or unfinished? Please Select Finished Unfinished Select any appliances that will come with the home:* RefrigeratorRangeMicrowaveDishwaherWasherDryer Is the property:* VacantOccupied Is the property a condo?* YesNo Any Association fees?* YesNo If Yes, how much? Please add any additional comments you feel are important about the property that were not covered above: Submit Should be Empty: Now create your own Jotform - It's free! Create your own Jotform
