Name        

Address:   

City:               

St:                  Zip: 

Email         

Phone:       

Information about the home you would like to sell:

Rate the Overall Condition:  (1- Poor, 10 - Excellent)      1 2 3 4 5 6 7 8 9 10

# of Bedrooms:    # of Bathrooms: 

Sq. Footage          Lot Size/acres: 

Parking Type: Garage Carport Lot Street        # of Spaces 

Year Built:      Basement Type: None Unfinished Partially Finished Finished

Heat Type:      Air Conditioning Type: 

# of Fireplaces:         Pool:   Yes  No

Planning to sell: Right Away 3-6 Months 6-12 months over 12 months

Additional Comments or Features