Your Name:  *

       Your Phone Number:  including area code *
       
           If you can receive information by fax what is the

               fax number  including area code?

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

               Address:  

               City:     

               State:      ZIP: 

                E-mail: *

                          School District:

                       

                 Whose name is the home titled in?

                        

    Current Occupancy?

                         Occupied by ownerRentedVacant

               How long have you owned this property?

                         Less than 1 year1-3 Years3-5 Years5-10 Years10-20 YearsLonger than 20 YearsI really don't know

                      What type of home is it?

                        Ranch (1 Story)Cape Cod (1 1/2 Story)2 StoryBi LevelRaised RanchSplit LevelEarth HomeCondoDuplexMobile HomeDouble WideModular or ManufacturedOther

                How many bedrooms?

                        1 Bedroom2 Bedrooms3 Bedrooms4 Bedrooms5 bedrooms6 or more bedrooms

                        How many baths?

                         1 Bath1 1/2 Baths1 Full Bath2 Baths2 1/2 Baths3 Baths3 1/2 Baths4 Baths4 1/2 Baths5 or more Baths

          What type of exterior siding do you have?

                          AluminumBrickStoneVinylWoodShingleStuccoCombinationOther

           What type of heating system do you have?

                  Natural Gas FurnacePropane Gas FurnaceGas Hot Water BoilerElectric Hot Water BoilerElectric FurnaceElectric BaseboardElectric Heat PumpElectric Radiant Heat (in the ceiling)Fuel Oil FurnaceWood Furnace AddonWood Stove (free standing)Wood Stove (fireplace insert)FireplaceOther

           What type of air conditioning do you have?

                           Central AirHeat PumpWindow AirWall Unit AirAttic FanOtherNone

                What type of garage do you have?

                         1 Car1 1/2 Car2 Car2 1/2 Car3 Car3 1/2 Car4 Car or LargerPole Barn/GarageAttached GarageDetached GarageCombinationOtherNone

                 What type of roof do you have?

                          ShingleSlateMetalTileWood ShakesCombinationOther

      How many square feet do you have above the basement?

                       Under 1,000 Square Feet1,000 - 1,500 Square Feet1,500 - 2,000 Square Feet2,000 - 2,500 Square Feet2,500 - 3,000 Square Feet3,000 or moreI 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?

                                  YesNo   

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

                          

                   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?