Information Sheet
Fill in the information as completely as possible so it can be processed quickly
First Name *
Last Name *
Address *
City *
State *
Zip *
email address *
Home Phone *
Work Phone
Mobile Phone
Is your property in foreclosure? *	Yes No
Auction Date
Property Parcel Number
Is your property listed? *	Yes no
How much
Listing expires
1st Lender *
Principle Balance *
Taxes & Inurance included? *	Yes No
Month of last payment *	January February March April May June July August September October November December
How many months deliquent?
Reinstatement
Interest rate *
The interest rate is *	Fixed Adjustable
Prepay Penalty *	Yes No
Expires
2nd Lender
Principle Balance
Monthly Payments
Month of last payment	January February March April May June July August September October November December
How many months deliquent
Reinstatement
Interest rate
The interest rate is:	Fixed Adjustable
Prepay Penalty?	Yes No
Expires
HOA *	Yes No
How much?
How often?
Are there any liens? *	Yes No
If yes, how much?
How much do you think your house is worth? *
How did you come up with that dollar amount? *
How much do you want for your house? *
Would you like to remain in the house? *	Yes No
If yes, how much can you afford each month?
What is the least you would take for an all cash quick close? *
Question, concerns, comments ...
How did you hear about us? *
Please check to make sure all the questions have been answered or the form will not process. Thank you