This form accomplishes one of two things:

Special Offer / Net Proceeds form

 
I am interested in:  
Special Listing Offer
Estimating my net proceeds
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Property Address
City
County
zip
State
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Name of Tract (if known)
Name of model (if known)
Number of bedrooms
Number of bathrooms
Approximate square footage
Special rooms and features that would add to value (please comment freely)
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Original price
Year you purchased the home
Balance on existing 1st mortgage
Balance on existing 2nd mortgage
Balances of any other liens
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Your estimate of value
Your estimate is based on)
similar sales in neighborhood
 
Realtor estimate
 
researched comps on internet
 
a reasonable guess
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Contact Information ....
name
email address
daytime telephone
night-time telephone
street address
city/state/zip
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