| Your Name: |
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| Your Phone: |
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| Your Email Address: |
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| Contact Information |
| Name: |
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| Address: |
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| County: |
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| Phone: |
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| Cell: |
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| Work: |
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| Email: |
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| Best Time/Number to Call: |
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| Hardship Summary: |
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| Value |
| When did you buy it? |
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| For how much? |
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| What do you think the property is worth? |
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| How do you know? |
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| Realtor® to Complete "As-Is" Values: |
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| BPO (call us to learn what this means): |
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| 7-14 Day |
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| 30-60 Day |
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| Debt |
| 1st
Mortgage Loan: |
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| Who is the lender? |
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| When is the sale date? |
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| How far behind (months)? |
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| How far behind (dollars)? |
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| How much is owed on the 1st mortgage? |
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| What type of loan? |
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| 2nd Mortgage Loan: |
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| Who is the lender? |
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| How far behind (months)? |
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| How far behind (dollars)? |
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| How much is owed on the 2nd mortgage? |
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| Any other liens (taxes, IRS, mechanics, assessments)
and dollar amount? |
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| House Details |
| Number of Bedrooms: |
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| Number of Baths: |
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| Age of Home: |
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| Square Footage: |
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| Lot size/Acres: |
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| Garage: |
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| Repairs Needed/Condition: |
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| Construction Type: |
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| Water: |
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| Sewer: |
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| Listed with Realtor®? Who? |
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| Misc. |
| Does your spouse know about this situation? |
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| Have you filed or considered bankruptcy? |
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| Type of bankruptcy filed: |
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| Date bankruptcy filed: |
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| Current stage of bankruptcy: |
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| What are your moving plans? (we prefer you remain
until
after short sale acceptance) |
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| We cannot process this request without the seller's permission to contact them. Do we have permission to contact this seller? | Yes |
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Submit this form electronically, or click here to download a form
you can fax (206-888-0473), mail or email. |
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