1. First Name
2. Last Name
3. Phone1
4. Phone2 (optional)
5. Email
6. Property Street Address, City, State, and Zip
7. What do you believe is the current value of your property?
8. How much do you owe on your mortgage?
9. Do you have a 2nd mortgage? If so, how much do you owe?
10. How much in repairs need to be done to your property?
11. Are you willing to let us lease your property for one of our tenants if your mortgage payment is covered by the rent we pay you?
If yes, check here:
12. What is the least you are willing to accept if our company purchases your property in its current condition in 30 days or less?
13. NOTES AND OTHER INFO: (optional)
14. Name of person filling out this form
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