Stop Foreclosure and Sell Your Home Fast

Fill out this form if you want to sell your house fast!
Please take a moment to fill out this confidential form. We will review the information that you give us and contact you ASAP. No matter what situation you are under, as long as you are flexible with us on price and terms and your house qualifies, we can help!
*Items marked with a red asterisk are required. If you are unable to answer a required question, give us your best guess or enter a "?", "N/A", "0", "don't know", etc. Please try to fill in all required questions.

Your Contact Information
*First Name(s)		*Day Phone (area code first)
*Last Name		*Evening Phone (area code first)
*Email		Cellular/Pager (area code first)
		*Best Time to Call

Your Situation
*Do you need to sell your house fast?	Yes No
*What is your situation? Why have you decided to sell your house?
*How soon do you need to move?

Your Property Information

*Address

*City

*State

*Zip Code

*County

Bedrooms

*Stories/Floors

Bathrooms

*Garage

Square Footage

*Basement

Year Built

*Lot Size/Acres

*How long have you owned this house?

*What is the current condition of your property?

*What kind of repairs and maintenance does the house need?

*How much do you think these repairs will cost?

*Is there anyone living in the house?

*How long has the property been for sale?

*Is the house currently listed with a realtor?

Yes No

*If Yes, when does the listing expire?

*If No, has the house been previously?

Yes No

Price & Terms

*How much are you asking us to pay for your house?

*How did you determine your asking price?

*If we were to have your house appraised, how much
do you think it would be worth?

	1st Mortgage	2nd Mortgage	3rd Mortgage
*Balance	$	$	$
*Payment	$	$	$
*Interest Rate	% Fixed Adj	% Fixed Adj	% Fixed Adj
*Payments Current?	Yes No	Yes No	Yes No
*If No, how far behind?	$	$	$
*How much are your total annual property taxes?			$
Other Questions
*Are your property taxes and insurance included in your monthly mortgage payment?			Yes No
*Do you pay Homeowner/Condo Association dues? If so, how much per year?			$

*Would you sell your house for what you owe on it?

Yes No Undecided

*Would you be willing to receive any of your equity, if applicable, in the form of monthly payments?

Yes No Undecided

*Would you be willing to sell your house by allowing us to take over your monthly mortgage payments?

Yes No Undecided

*If we were able to buy your house in 7 Days or less,
what is the least you could accept?

*How did you hear about us?

Do you have any questions or comments you would like to share with us?

When you have finished filling out this form please click on the send button to submit your information to us. Clicking the Reset button will clear out the form. Thank you for taking the time to share your home with us.

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