1. Contact Information (* indicates a required field)
First Name: *

Last Name: *

Phone:

Fax:

Email: *
Street Address

City:

State/Province:

Zip/Postal Code:
   
2. Property Information (Describe the home that you wish to sell)
Property Type: (Single-Family, Condo, Duplex, etc.)

Number of Bedrooms:

Number of Bathrooms:

Square Footage of Home:

Lot Size:

Age of Home (year built):

Street Address:

City:

Zip Code:


Please check each of the following features that apply:
Great Room
Den
Formal Living Room
Formal Dining Room
Bonus Room
Basement
Fireplace
Pool
View

If you have a view, please describe (ocean, lake, pond, etc.)

What type of air conditioning?
Central Air
Wall Unit(s)

What type of heat?
Gas
Electric

What type of Garage?
Attached
Detached
Carport
No Garage

Size of Garage?
One Car
Two Car
Three Car
Four Car
No Garage

Any upgrades that should be considered?

Additional features or comments?

Are you currently working with another REALTOR®?
Yes
No