Seller Information Form

If you need to sell your house quickly, please complete the following form and submit it
online, or print the form out and fax it to us at our number listed on the Contact Us
page. For immediate attention, you can call us and we can discuss your particular

Please complete as much of the form as possible.
If you are unsure of the information or uncomfortable, fill out whatever you can and we will determine the rest with you later.  Note the minimum required fields *.

In any case, you can rest assured that we will always respect and protect your privacy.

Note: Feel free to use as much space as you need for each category; the text will scroll.

*Required Fields

Day Phone*
Evening Phone*
Cell Phone*
Best Time to Call*
Do you own this house? If Not, What is the Owner's Name(s)?

How did you hear about us?

Tell us about your house for sale:

Zip Code*
How Many Bedrooms?
How Many Bathrooms?
Approx. Square Footage? sq. ft.
Approx. Acres? acres
Style (Colonial, Ranch, etc)?
Year Built?
Years Owned? yrs.
Garage? If Yes, How many cars?
Does the house need work? If Yes, Please Explain below:
How much will this work cost?
Any extra info about house? Add extra info about the house below:
Is the house currently listed with a realtor? If Yes, When does the listing expire?


How much are you asking?
What do you think its worth?
How did you arrive at these prices?
If we paid all cash to buy your house in 9 days or less, what is the least you would accept?

Financial Information:

Mortgage Balance  1st: 2nd: 3rd:
Mortgage Payments  1st: 2nd: 3rd:
Mortgage Interest  1st: 2nd: 3rd:
Are Payments Current?  1st:       2nd:       3rd:
If No, How far behind?  1st: 2nd: 3rd:
Are Taxes & Insurance Included in the Mortgage?  

Thank you for taking the time to fill out the form!