If you can receive information by fax what is the fax number?
include area code

What is the mailing address of the home you want to sell:

Address:

City:

State: ZIP:

Whose name is the home titled in?

Are you living in the home, is it rented or is it vacant?
Living in the home Renting the home The home is vacant

How long have you owned this property?
Less than 1 year 1-3 Years 3-5 Years 5-10 Years 10-20 Years Longer than 20 Years I really don't know

What type of home is it?
Ranch (1 Story) Cape Cod (1 1/2 Story) 2 Story Bi Level Raised Ranch Split Level Earth Home Condo Duplex Mobile Home Double Wide Modular or Manufactured Other

How many bedrooms above the basement?
1 Bedroom 2 Bedrooms 3 Bedrooms 4 Bedrooms 5 bedrooms 6 or more bedrooms

How many baths?
1 Bath 1 1/2 Baths 1 Full Bath 2 Baths 2 1/2 Baths 3 Baths 3 1/2 Baths 4 Baths 4 1/2 Baths 5 or more Baths

What type of exterior siding do you have?
Aluminum Brick Stone Vinyl Wood Shingle Stucco Combination Other

What type of foundation do you have?
Full Basement Partial Basement Crawl Space Concrete Slab Combination Other

What type of heating system do you have?
Natural Gas Furnace Propane Gas Furnace Gas Hot Water Boiler Electric Hot Water Boiler Electric Furnace Electric Baseboard Electric Heat Pump Electric Radiant Heat (in the ceiling) Fuel Oil Furnace Wood Furnace Addon Wood Stove (free standing) Wood Stove (fireplace insert) Fireplace Geothermal Other

What type of air conditioning do you have?
Central Air Heat Pump Window Air Wall Unit Air Attic Fan Geothermal Other None

What type of garage do you have?
1 Car 1 1/2 Car 2 Car 2 1/2 Car 3 Car 3 1/2 Car 4 Car or Larger Pole Barn/Garage Attached Garage Detached Garage Combination Other None

What type of roof do you have?
Shingle Slate Metal Tile Wood Shakes Combination Other

How many square feet do you have above the basement?
Under 1,000 Square Feet 1,000 - 1,500 Square Feet 1,500 - 2,000 Square Feet 2,000 - 2,500 Square Feet 2,500 - 3,000 Square Feet 3,000 or more I have no idea

Tell me about any recent improvements or updates
that you think will help your homes resale:

Have you had the home appraised within the past 5 years?
Yes No

Where would you estimate the value of your home to be?

What would happen to your plans if it sold for less than that figure?

What is a good time to contact you to set up
a time for us to view your home?