Owner's Name:	*
Street address:
City:	State: *   Zip: *
Your Name (if other than owner):
Phone Number(s):	*
Best Time to Reach You:
Email Address:	*
Neighborhood (Tract Name or Number):
This is My: Primary Residence .. Second Home .. Rental/Income Property ..
Type of Property: Single Family Residence .. Condo/Townhome .. Apartment ..                             Land .. Other ..
Style of Home: Ranch(1 story) .. Two Story .. Tri-level .. Duplex .. Other ..
Approx. Age of Home: Years
Number of Bedrooms:       Number of Bathrooms:
Number of Fireplaces:       Approximate Square Footage: sq.ft.
Garage: One Car .. Two Car .. Three Car .. Carport .. None
Do you have: Pool     Spa     Patio     Deck     Built-in Bar-B-Que >
Any Additions or Modifications to Original Floor Plan? Any Improvements or Information that you believe may increase or decrease the value of your home compared to other homes in the area:
How would you rate the general condition of your home? Excellent     Good     Fair     Poor
How many homes have you sold in the past? 0     1     2     3 or more
When are you planning to sell this home? 1-3 months     3-6 months     6 months+
Are you staying in the area or relocating to another city?
Is your home: Currently listed with a Realtor ?     For Sale by Owner ?
Please make sure that all the * required fields have been entered.