PROPERTY SUBMISSION FORM

**** ALL INFORMATION WILL REMAIN CONFIDENTIAL ****

CONTACT  INFORMATION
Submitter's Name *
Mailing Address
City State Zip Code
 
Phone:
Cell:
Fax:
Email: *
How did you hear about us? *
PROPERTY DESCRIPTION
Property Owner's Name *
Property Address *
City * State * Zip Code
County
Year Built?
# Years You've Owned?
Subdivision Name
Heating System?
Cooling system?
Style of Home
# of Bedrooms
# of Bathrooms
  Square footage
  Foundation
  Exterior
  Garage
  Lot size
City water?
  Yes    No  
City sewer?
  Yes    No  
Need Repairs?
  Yes    No  
List Repairs
MORTGAGE INFORMATION
Are you looking to sell your home for what you owe? *
 Yes    No  
1st Mortgage Co. Name
2nd Mortgage Co. Name
Total Amt Other Liens?
1st Mort Balance *
2nd Mort Balance *
Annual Taxes?
1st Mort Payment *
2nd Mort Payment *
Annual Ins. Premium
Amount Behind *
Amount Behind *
Are Tax/Ins in Mo Pay?
 Yes    No  
 * Required Fields

     
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