CONTACT
INFORMATION
Name (First, Last):
Address of Property:
City:
State:
--
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
DC
WV
WI
WY
GU
PR
VI
Zip:
Email:
PROPERTY
INFORMATION
Resident Status:
Primary
Residence
Secondary
Residence
Vacation
Home
Rental
# of Bedrooms:
Choose
One
0
1
2
3
4
5
6
7
8
9
10
Relationship:
Legal
Owner
Renter
Landlord
Property
Manager
Potential
Buyer
Other
# of Bathrooms:
Choose
One
0
1
1.5
2
2.5
3
3.5
4
4.5
5
Type of Property:
Choose
One
Single
Family Home
Multiple
Family Home
Townhouse
Condominium
Manufactured
Home
Mobile
Home
Parking:
Choose
One
Garage
Carport
On Street
Off Street
No
Covered Parking
Overall Condition:
Choose
One
1 Poor
2
3
4
5
6
7
8
9
10 Excellent
Spaces:
Choose
One
None
1 Car
2 Cars
3 Cars
More
than 3
Lot Size / Acreage:
Choose
One
City Lot
1/2 Acre
1 Acre
2-5 Acres
5-10
Acres
10+ Acres
Unsure
Listing Status:
Not
Currently Listed
For
Sale by Owner
Yes
- With an Agent
Approx. Square Footage:
Select
One
Under
1,000
1,000
- 1,250
1,250
- 1,500
1,500
- 1,750
1,750
- 2,000
2,000
- 2,500
2,500
- 3,000
3,000
- 3,500
3,500
- 4,000
4,000
- 4,500
4,500
- 5,000
Over
5,000
Planning to Sell:
Choose
One
Right
Away
90 Days
6 Months
12 Months
Basement:
Choose
One
Finished
Partially
Finished
Unfinished
None
How did you hear
about Us?
Choose
One
Other
TV
Postcard
Sign
Radio
Online
Newspaper