SELLER FORM

To better assist you, please fill out the form below. Answering the questions below should only take a few minutes but will allow us to determine which solutions will work best for you. We will get in touch with you within 24 hours. For a faster response, you may contact us directly at 281-772-1786. All information submitted is strictly confidential and will not be shared without your consent.

Questions marked with a red asterisk (*) are required. You may enter “0”s if you are unable to answer a required question. If you have any problem submitting this form, please contact us and let us know.

Current Time:
* First Name:
* Last Name:
* Mobile Number:	(ie:7131234567)
* Work Number:	(ie:7131234567)
* Home Number:	(ie:7131234567)
Fax Number:
* Email Address:
* Why are you selling your home?:
* How did you hear about us?:
* Address:
* City:
* State:
* Zip Code:
Square Feet:
Year Built:
Stories or Floors:
Bedrooms:	1 2 3 4 5 6 7+
Bathrooms:	1 2 2.5 3 3.5 4+
Condition of House:	Excellent Good Fair Poor Teribble
Listed with Realtor:	Yes No
Repairs Needed and Estimated Costs:
How much is the house worth?:
* What is your asking price?:
Would you sell your house for what you owe?:	Yes No Undecided
Name of Lender:
First Mortgage Balance:
Payment current?:	Yes No
If no, how far behind?:
Second Mortgage Balance:
Payment current?:	Yes No
If no, how far behind?:
Total Monthly Payment:
Tax and Insurance included?:	Yes No
Posted for foreclosure?:	Yes No
Have you filed bankruptcy?:	Yes No
If we were able to buy your house in 7 Days or less, what is the least you could accept? :

 

Phone: 281-772-1786 Fax: 713-457-5141 E-mail: buymyhouse@instanthomeremedy.com

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