Name(s), including middle initial
Email Address
Phone Number
Business Phone
Cellular or Pager
Address
County
City
State
Zip
Street address of subject property
Full legal description of property
Present owner of subject property
Is the owner an individual, an estate, a corporation or a partnership? Yes No
Is the property commercial or residential?
What is your intended use of the property?
Is the property mortgaged? Yes No
First mortgage balance
First mortgage company
Is the first mortgage current? Yes No
If not, amount behind?
Second and other subordinate mortgage balances, if any
Subordinate mortgage company
Are any second or other subordinate mortgages current? Yes No
Are there any other liens on the property?
If so, please describe
Tax assessed value of property
Are there any taxes due on the property? Yes No
If so, please list
If applicable, to whom do you want to transfer the property?
Is there a title company working on this matter? Yes No
If so, please list contact information
Is there a real estate or other broker representing you on this matter? Yes No
Are there any renters currently on the property? Yes No
Please describe any current legal proceedings (such as foreclosure, tax suits. lis pendens, eminent domain, etc.) involving the property.
What is your desired result (such as purchase, sell, mortgage, clear title, etc.)?
Special concerns or other relevant information
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