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1. Contact Information
* First Name : 
* Last Name : 
* Address 1 : 
   Address 2 : 
* City : 
* State : 
* Zip : 
* Phone : 
* Email Address : 
 
 
 
2. Preferred Method of Contact (Select all that apply)
 
Phone
 
Email
 
Text
 
Other
 

 
 
 
3. Full Property Address:
   
 
 
 
4. Number of Bedrooms and Bathrooms (BDR/BTH):
   
 
 
 
5. Square Footage
   
 
 
 
6. Condition of Property (Select all that apply)?
 
Move-In Ready
 
NOT Move-In Ready
 
Needs Minor Repairs
 
Needs MAJOR Repairs

 
 
 
7. Is the Foundation and Roof in Good Condition?
 
Yes
 
No (Explain)
 
 
 
 
8. Estimate of Needed Repairs
   
 
 
 
9. What is Your Asking Price?
   
 
 
 
10. Additional Info About Property:
   
 
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