| Your Contact Information |
| Name:* |
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| Phone:* |
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| FAX: |
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| Email:* |
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Information About Your Property |
| Address* |
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| City* |
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| State* |
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| Zip Code* |
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| School District |
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| Name on Title* |
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| Property Status* |
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| How Long Have You Owned the Home* |
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| Home Type* |
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| Bedrooms Above Basement* |
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| Baths* |
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| Exterior Siding Type* |
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| Foundaton Type* |
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| Heating System* |
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| Air Conditioning System* |
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| Garage* |
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| Roof Type* |
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| Square Footage Above Basement Sale* |
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| Other Information that May Assist in the Sale of Your Home |
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| Has the Home Been Appraised in the Past 5 Years* |
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| Please Estimate the Value of Your Home* |
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| What Would Happen To Your Plans if the Home Sold at a Lower Price? |
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| When Can I Contact You* |
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