Real Estate Contact Form

*First Name

*Last Name

*Email Address

*Phone Number

*Zip

Street Address

Apt/Ste

Incident Street Address

Incident Apt/Ste

*Incident Zip

Business Phone

Cellular or Pager

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 

If not, amount behind?

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 

If so, please list contact information

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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