INTERESTED IN SELLING?

Please complete as much of the following as you can,
   so I can promptly respond to your request.

Name:

Co-Owner:

Property Address:

City:   State:   Zip Code:

Email Address:

Home Phone (with area code):

Work Phone (with area code):

Is You House Currently Listed? Yes | No |

What is the Approximate Square Footage of Your Home? LESSTHAN 1000 SF 1000 - 1500 SF 1500 - 2000 SF 2000 - 2500 SF 2500 - 3000 SF 3000 - 3500 SF 3500 - 4000 SF 4000 - 4500 SF 4500 - 5000 SF OVER - 5000 SF

Number of Bedrooms: TWO THREE FOUR FIVE OR MORE NONE - LAND

What is the Age of your Home? NEW 1 - 5 YEARS 6 - 10 YEARS 10 - 15 YEARS 15 - 30 YEARS 30 YEARS OR MORE

When Would you like Your Home to go on the Market? IMMEDIATLY TO 15 DAYS 15 - 30 DAYS 30 - 45 DAYS 45 - 90 DAYS 90 - 120 DAYS 120 -180 DAYS 180 - 360 DAYS 1 YEAR OR MORE

Additional Comments: