Contact Information:
Name:
Address:
City:
State:
Zip Code:
Phone:
E-mail:
How did you find us?:	Please choose a source... Ink Pen Google Yahoo Homefront Ad MSN Friend Realtor.com Realestateabc.com
Property Description
In whose name is the property titled?:
Occupancy Status:	Please make a selection... I am living in the home I am renting the home The home is vacant
When did you purchase the property?:
Number of Bedrooms?:	1 2 3 4 5 6 7 8
Number of Bathrooms?:	1 1.5 2 2.5 3 3.5 4 5 6
Type of Property: (Please select all that apply)	Single Family Condo Townhouse Manufactured Mobile Duplex
Lot Size?:
Pool?:	Yes No
Garage (Size, Attached, etc...)
Square Footage:
Year Built?:
Property Improvements
Have any improvements been made that would increase the home's value?:
Home was appraised in the last 5 years. :	Yes No
What do you think your home is worth?:
Any other special features?:
How well will property show to clients?:	Please make a selection... Excellent Good Fair Needs Work
Home values can vary by more than 10% when we can't see inside your home. Is it possible to walk-through your home? (This is not required):	Yes No