Seller Information
First Name:
Last Name:
Primary Phone:	-   -
Cell Phone / Alternate:	-   -
Best time to Call:	Select Any Early Morning Morning Afternoon Early Evening Evening I'm up all night
Email:
Property Information
Property Type:	Select Single Family Condo Townhouse Manufactured Home Multi-Family 2/3/4 Plex Warehouse Shopping Center Office Building Land Other
House Number:
Direction:
Street Name:
Unit/Apt:
Suffix:	Select Ave Blvd Cir Ct Dr Hwy Ln Loop N/A Pass Pkwy Pl Rd Rdg Run St Sq Ter Trce Trl Way Other
City:
State:	Select FL AL AK AS AZ Fl CA CO CT DE FM FL GA GU HI ID IL IN IA KS KY ME MH MD MA MI MN MS MO MT NE NV NH NJ NY NC Fl MP OH OK OR PW PA PR RI SC SD TN TX UT VT VI VA WA WY AE AA AE AP Others
County:	Select Miami-Dade Broward Palm Beach Monroe Other
Zip Code:
Bedrooms:	Select 1 2 3 4 5 6 7 8 9 10 10+
Bathrooms:	Select 1 2 3 4 5 6 7 8 9 10 10+
Half Bathrooms:	Select 1 2 3 4 5 6 7 8 9 10 10+
Square Footage:	Select N/A 0-500 500-750 750-1,000 1,000-1,250 1,250-1,500 1,500-1,750 1,750-2,000 2,000-2,500 2,500-3,500 3,500-5,000 5,000-7,000 7,000-10,000 Over 10,000
Is the property listed with a Realtor now?	No Yes Thinking about it
If so, what is the list price?	Select Not Listed Under $100,000 $100,000-$150,000 150,000-$200,000 $200,000-$300,000 $300,000-$400,000 $500,000-$750,000 $750,000-$1,000,000 Over $1,000,000
Why are you selling?	Select Bankruptcy Code Violation(s) Get out of Debt Death of Spouse Illness Inherited Investor Flip Job Transfer Need Cash Other Pending Bank Foreclosure Relocating Sick of Tenants Upgrading Want to get out of this town! Zoning Violation(s)
How soon do you want to sell?	Select As soon as possible Within the next 2 weeks 3 to 4 weeks 5 to 7 weeks 2 to 4 months 5 to 6 months More than 6 months
When did you aquire the property?	Select 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1999 1988 1987 1986 1985 1984 1983 1982 1981 1980 Prior to 1980
Do you have a mortgage?	Yes No
If so, what is owed?
Estimated value of the property:
How did you find us?	Select Community Newspapers The Flyer Google Direct Mail Internet Seach Referred by Past Seller Attorney Other
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