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First Name:
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Last Name:
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E-mail:
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How did you hear about my website?:
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Internet Search
Chamber of Commerce
Other Web Site
Another Real Estate Firm
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Other
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Your Phone Number:
Fax Number
Allowed to Call?
Yes
No
What is the mailing address of the home you want to sell:
Address:
Address (cont).:
City:
State:
ZIP:
Country:
What is your school district?:
Whose name is the home titled in?
Are you living in the home, is it rented or is it vacant?
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Living in the home
Renting the home
Not in the home, it is vacant.
How long have you owned this property?
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Less than 1 year
1-3 Years
3-5 Years
5-10 Years
10-20 Years
Longer than 20 Years
an Unknown amount of time
What type of home is it?
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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?
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1
2
3
4
5
6+
How many baths?
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1
1 1/2
1 Full
2
2 1/2
3
3 1/2
4
4 1/2
5+
What type of exterior siding do you have?
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Aluminum
Brick
Stone
Vinyl
Wood
Shingle
Stucco
Combination
Other
What type of foundation do you have?
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Full Basement
Partial Basement
Crawl Space
Concrete Slab
Combination
Other
What type of heating system do you have?
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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?
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Central Air
Heat Pump
Window Air
Wall Unit Air
Attic Fan
Geothermal
Other
What type of garage do you have?
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1 Car
1 1/2 Car
2 Car
2 1/2 Car
3 Car
3 1/2 Car
4 Car or Larger
Pole Barn
Attached
Detached
Combination
Other
What type of roof do you have?
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Shingle
Slate
Metal
Tile
Wood Shakes
Combination
Other
How many square feet do you have above the basement?
Choose One
Under 1,000
1,000 - 1,500
1,500 - 2,000
2,000 - 2,500
2,500 - 3,000
3,000+
Unknown
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
What would you estimate the value of your home to be? Number format only. Example: 150,000.00
What would happen to your plans if it sold for less than that figure? Number format only. Example: 150,000.00
What is a good time to contact you to set up a time for us to view your home?
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