Name:
Home Phone Number:
Work Phone Number:
Cell Phone Number:
E-mail Address:
What is the address of the home you wish to
sell?
Street Address:
City:
State:
Zip:
What school district is the home in?
What style home is it?
Click to
select Colonial Ranch
Split Level Town
house
Raised Ranch
Cape Cod
Bungalow
Two Story
Row House
Any style home Other
How many bedrooms?
1 Bedroom
2 Bedrooms 3 Bedrooms 4
Bedrooms 5 Bedrooms 6 or more
Bedrooms Click to select
How many bathrooms?
Click to
select 1 Bath 1-1/2 Baths
2 Baths 2-1/2 Baths 3
Baths 3-1/2 Baths 4 Baths or
more
What size garage do you have?
Click to
select 1 Car 2 Car 3
Car 4 Car 5 Car or
more
Are you living in the home, is it rented or is it
vacant?
Click to
select Living in the home Home is
rented Home is vacant
How long have you own this property?
Click to
select 1 year 2-3 years
4-5 years 6-8 years 9-12
years Over 12 years Don't
know
When do you need to have the home sold and closed by?
In terms of square feet what is the size of the home?
Click to
select Under 1000 square feet
1000-1500 square feet 1500-2000 square
feet 2000-2500 square feet 2500-3000
square feet Over 3000 square feet
What would you estimate the value of the home to be?
Would the final selling price affect your plans to sell?
Have you ever sold a home before?
Have you ever hired a realtor before?
Referred by:
What are your concerns about selling your home?
What criteria will you use to select a realtor?
