$
$
% Fixed*Adj*
Yes No
$

Second Mortgage:

$

$

% FixedAdj

Yes No

$

Third Mortgage:

$

$

% FixedAdj

Yes No

$

*How much are your total annual property taxes?        $

*Are your property taxes and insurance included        Yes    No
 in your monthly mortgage payment?

Do you pay Homeowner/Condo Association dues?           $
If so, how much per year?

*Would you sell your house for what you owe on it?   Yes  NoUndecided

*Would you be willing to receive any of your        Yes  No Undecided
  equity, if applicable, in the form of monthly
  payments?

*Would you be willing to sell your house by        Yes  No Undecided
  allowing us to take over your monthly
  mortgage payments?

*If we were able to buy your house in 7 Days or less,  $
  what is the least you could accept?

*How did you hear about us?                             

Do you have any questions or comments you would like to share with us?

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submitting this form, please contact us and let us know.