Full Name
Spouse
Home Phone
Cell Phone
Spouse Cell Phone
Work Phone
Address
City
State
Zip
Country
Email
Spouse Email
How did you hear about us?	Google Craig’s List Flyer Friend Sign Other
Are you looking to:	Buy    Rent    Sell    Short Sell    Lease Option
Property address
What are the major cross streets?
What is the closest highway?
How many bedrooms does it have?
How many bathrooms does it have?
What is the approximate square footage?
Is it currently on the market with a Real Estate Company?
Are you committed to them?	yes    no
How much is your first mortgage?
What is the loan type?	Adjustable    Fixed
What is the current payment?
Are the payments on your first mortgage current?	yes    no
If not, how behind are you?
What is the mortgage term?
How much is your second mortgage? (if applicable)
What is the second loan type?	Adjustable    Fixed
What is the current second payment?
Are the payments on your second mortgage current?	yes    no
If not, how behind are you on your second mortgage?
What is the second mortgage term?
How much do you currently owe? (first and second mortgage)
How much do you want to net on the sale of your property?
Is the house a:	Single Story Double Story Patio Duplex Split Level
Does the property have:	Pool    Upgraded Appliances    RV Gate    Fireplace    Washer/Dryer    Granite Countertops    Gated Community
Does this property have an HOA?	yes    no
What are the HOA fees?
Additional comments:
Inital contact person?	Bobby Evan Erica Kayla Kristina Chastity Charlotte Ashley John Ceci Wes Teresa Grand Central
Initial contact date?	Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 19911992199319941995199619971998199920002001200220032004200520062007200820092010