Your Company Name We Buy Houses Quickly

You Want To Sell? We Want To Buy

When you fill out the property information form below we will contact you within 48 hours in regards to buying your house at a fair price on the date of your choice.

If you'd rather talk to someone right now instead, you can call 24 hours a day, 7 days a week and we can start the process now (555) 555-5555

Property Information Form

Name
Email Address
Telephone #
Why are you selling?
How soon do you want to move?
Your Property's Information
Address
City
State
Zip Code
Is your house listed with a Realtor?	Yes No
If Yes at what price?
Does your house need repairs?	Yes No
If Yes how much do you think these repairs would cost?
Your Sale And Loan Information
How much are you asking us to pay for your house?
How did you determine asking price?
If you had your property appraised how much do you think it will be worth?
1st Mortgage
Balance
Monthly mortgage payment
Does this include insurance and taxes?	Yes No
Interest rate
Payments behind?	Yes No
If Yes how far behind?
2nd Mortgage
Balance
Monthly mortgage payment
Monthly mortgage payment
Does this include insurance and taxes?	Yes No
Interest rate
Payments behind?	Yes No
If Yes how far behind?
Would you be willing to sell your house by allowing us to take over the payments?	Yes No
How did you hear about us?