Fast Response Form

Following is our FAST response form. Fill out this form as completely as possible and we will promptly contact you to discuss your options.

The information you provide on this form will remain confidential

Tell us about you...
Your name:
E-mail address:
Daytime phone:
Evening phone:
Best time to call:
Tell us about the property...
Property street address:
Property city and state:
Property zip code:
The Property is currently:
Bedrooms:
Baths:
Square footage:
Age of House:
Garage:
What is the general condition of the house?
Please describe any needed repairs in this box
Check all that apply
Wood Floors			Formal Dining Room
Carpeting			Game Room
Tile			Fireplace
Finished Basement			Deck
Unfinished Basement			Swimming Pool

Privacy Fence			Other Fence
Brick			Vinyl Siding
Steel Siding			Wood Siding
Other Siding			Stucco

Central Heat			Central Air
Floor Furnace			Wood Stove
Septic Tank

Crawl Space			Slab
Storage Shed			Shop
Tell us about the numbers...
How much do you feel the property is worth?
1st mortgage balance:
1st mortgage payment amount:
Does the 1st mortgage payment include taxes and insurance?
Are there other mortgages on the property:
What is the combined balance of all mortgages?
What is the combined monthly payment on all mortgages?
Please tell us about any other liens and/or other title problems that may affect this property by typing an explanation here.

Are all mortgage payments current? If payments are current click here to skip this section
If payments are not current, how far behind are they?
	1st mortgage	$ Amount behind		# of payments
	2nd mortgage	$ Amount behind		# of payments
	Other mortgage	$ Amount behind		# of payments
Have you received a foreclosure notice:
Has a foreclosure sale date been set:
Sale date:
Just a couple more questions...
Is your property currently listed with a real estate agent/broker?
If property "is" listed, when does your listing expire?
Are you currently in bankruptcy?
How did you hear about us?
Please provide any further comments that you feel are important in the box below...
Comments