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Do You Need to Sell Your House Fast or Stop Foreclosure Now?
Regardless of your situation, if your house qualifies and you are flexible on price and terms,
C O N F I D E N T I A L
Items marked with a red asterisk (*) are required.
Your Contact Information
*First Name(s)
*Last Name
*Email
*Day Phone
 x 
*Evening Phone
 x 
Cell/Pager
 x 
*Best Time to Call
Your Situation
*Do you need to sell your house fast or stop foreclosure now? Yes   No
*What is your situation? Why are you selling?
*How soon do you need to move?
Your Property Information
*Address
*City
*State
*Zip
*County
Home Style *Stories/Floors
*Bedrooms *Garage
*Bathrooms Basement
*Square Footage Lot Size/Acreage
Construction
*Year Built
*What month and year did you purchase this house?  format: mm/yyyy
*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?     format: mm/dd/yyyy
          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 ARM 		   %
Fixed ARM 		   %
Fixed ARM
Payments Current? Yes  No Yes  No Yes  No
If No, how far behind? $ $ $
*How much are your total annual property taxes? $
*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?
C O N F I D E N T I A L

Thank you for taking the time to share your home with us.

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SELL YOUR HOUSE TO US
2500 Quantum Lakes Drive
Suite 203
Boynton Beach, FL 33426
Contact Us Now!
Primary Phone 561-953-0089
Toll Free 877-572-5951
Free 24 Hr/Msg 877-572-5951
Fax 877-572-5951