Your Name (First, Last):
Address of Property (Street Number, Street Name)
City:
State, Zip:
Home Phone:
Cell Phone:
E-Mail:
Property Type:	Primary Residence Vacation Home Investment Property
Property Style:	Single Family Home Townhouse Condominium Villa Multiple Family Home Manufactured Home Mobile Home
Approximate Year Built:
# of Bedrooms:
# of Full Bathrooms:
# of Half Bathrooms:
# of Fireplaces:
Approximate Heated Square Footage: (Garage, Basement, non-enclosed Porch or Lani excluded)
Lot Size / Acreage:	Choose One Up To 1/4 Acre 1/2 Acre 1 Acre 2-5 Acres 5-10 Acres 10+_Acres Unsure
Heating Type:	Choose One Electric Gas Oil
Air Conditioning Type:	Choose One Central Air Window Unit None
Pool:	Choose One Owned Community None
Parking:	Choose One 1 Car Garage 2 Car Garage 3 Car Garage More Than 3 Car Garage Carport Parking Pad No Gargae
Rate Your Home's Overall Condition:	Choose one 1 Poor 2 3 4 10 Excellent
Property Features:	Choose one Waterfront Gated Community Golf Course Frontage
Additional Comments: (The more information you provide, the more accurate your home evaluation will be.
When are you planning to sell?	Right Away 90 Days 6 Months 12 Months
What city will you be moving to?
Is your home currently listed?	Yes - With an Agent For Sale by Owner Not Currently Listed