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Your E-Mail Address: Example: name@aol.com Primary Owner Name: Co-Owner Name: Property Address: City: County: State: TN AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN UT TX UT VA VT WA WI WV WY Zip Code: Day Phone: Example: (000) 123-4567 Evening Phone: Example: (000) 987-6543 Cell Phone: Example: (000) 456-2134 Property Type: Select your property... Single Family Residence Condominium Townhouse Other Sorry, no mobile homes. Is your property currently listed with a Realtor? No Yes If yes, at what price and listing expiration date. Name of Community or Subdivision: Number of Bedrooms: Number of Bathrooms: Garage # of cars: Pool? Choose one... None Above Ground In Ground HVAC (heating & air) type: Approximate age of HVAC system: Number of stories: Roof type: Roof age: Homeowners' Assoc. Dues: Construction Type? Wood Frame Brick Concrete Block Year Built: Example: 1971 Square footage of house: Basement? Yes No When did you purchase this property? Example: 1971 Overall condition of property? Unlivable Needs major work Needs minor repairs Perfect condition When are you looking to close? What is your asking price? Are you negotiable? Yes No Is the property vacant? Yes No If a move is scheduled, when is your moving date? Are your payments current? Yes No What do you owe on the property? Why are you selling? Please explain your situation. Is the property involved in a bankruptcy? Yes No What is the most convenient time to call you? When is the best time to meet with you at the property? How did you hear about us? Internet Newspaper ad Friend Other