Please provide the following Contact and Other information:

	Contact Info                                           Property Address
First Name*	Street
Last Name*	City
Work Phone	xxx-xxx-xxxx     State
Home Phone*	xxx-xxx-xxxx      Zip
E-mail*	County
	Property Info
Type of Home	Single Family Home Town House Condo Multi Family Other Mobil Home   # Bedrooms 1 2 3 4 5+     Baths 1 2 3 4+   1/2 Bath 0 1 2
Sq. Ft.	500-1000 1000-1500 1500-2000 2000-2500 2500-3000 3500+      Home Age 1-3 Years 3-5 Years 5-7 Years 7-10 Years 10-15 Years 15-20 Years 20-25 Years 25-30 Years Older House is Ok       Garage 1 2 3 Carport No Garage No Carport
Home Condition	Needs Work Needs Lot of Work Very Good Good Fair Excellent               Pool Yes No      Water Front Yes No
Construction	Block Brick Frame Other   Floors   1 2     # of Trees 0 1 2 3        Tree Sizes Small Medium Big Large
Occupied	Yes No   If Not Occupied   Vacant Rented       If Rented (How much Rent)
	Financial Info
1st Loan Balance	Mo Payment  Payment Behind 0 1 2 3 4 5 6 7 8 9 10 11 12 12+ Int Rate 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15+
2nd Loan Balance	Mo Payment  Payment Behind 0 1 2 3 4 5 6 7 8 9 10 11 12 12+ Int Rate 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15+
3rd Loan Balance	Mo Payment  Payment Behind 0 1 2 3 4 5 6 7 8 9 10 11 12 12+ Int Rate 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 12-13 13-14 14-15 15+
Liens on Property	Lien 1            Lien 2            Lien 3
House Value	If fix up needed how much?
	Deed and Mortgage Info
Names on Deed	Second Person        Third Person
Names on Mortgage	Second Person    Third Person
Selling Info	Appraised for     Sell it for
If I Buy it TODAY,	ALL CASH, AS-IS, What is the very LEAST you would sell it for?
When Can we	Meet?       ASAP Today Tomorrow Call me Now
	Please Note your information is100% CONFIDENTIAL