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CONTACT INFORMATION
Name (First, Last):*
Address of Property:*
City:*		State/Province:*	Choose One AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY --Canada-- AB BC MB NB NL NS NT NU ON PE QC SK YT	Zip/Postal Code:*
Email:*		Phone:

PROPERTY INFORMATION
Resident Status:*	Choose One Primary Residence Secondary Residence Vacation Home Rental		# of Bedrooms:*	Choose One 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Relationship:*	Choose One Legal Owner Renter Landlord Property Manager Potential Buyer Other		# of Bathrooms:*	Choose One 0 1 1.5 2 2.5 3 3.5 4 4.5 5
Type of Property:*	Choose One Single Family Home Multiple Family Home Townhouse Condominium Manufactured Home Mobile Home		Parking:*	Choose One Garage Carport On Street Off Street No Covered Parking
Overall Condition:*	Choose One 1 Poor 2 3 4 5 6 7 8 9 10 Excellent		Spaces:*	Choose One None 1 Car 2 Cars 3 Cars More than 3
Lot Size / Acreage:*	Choose One City Lot 1/2 Acre 1 Acre 2-5 Acres 5-10 Acres 10+ Acres Unsure		Listing Status:*	Choose One Not Currently Listed For Sale by Owner Yes - With an Agent
Approx. Square Footage:*			Planning to sell:	Choose One Right Away Within 90 Days Within 6 Months Within 12 Months
Basement:*	Choose One Finished Partially Finished Unfinished None		Heat Type:
Style of Home:			Air Conditioning Type:
Approx Year Built:			Neighborhood:
# of Fireplaces:			Pool:	No Yes
Where will you be moving:
Additional Comments:
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