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Name:
Phone Number **Required To Submit** Example Format Is: 302-398-3757
Email Address:
Street Address:
YOUR STATE:	AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VI VT WA WI WV WY
How Old Is Your Home?	1 Year Old 2 Years Old 3 Years Old 4 Years Old 5 Years Old 6 Years Old 7 Years Old 8 Years Old 9 Years Old 10 Years Old 11 Years Old 12 Years Old 13 Years Old 14 Years Old 15 Years Old 16 Years Old 17 Years Old 18 Years Old 19 Years Old 20 Years Old 21 Years Old 22 Years Old 23 Years Old 24 Years Old 25 Years Old 26 Years Old 27 Years Old 28 Years Old 29 Years Old 30 Years Old 31 Years Old 32 Years Old 33 Years Old 34 Years Old 35 Years Old 36 Years Old 37 Years Old 38 Years Old 39 Years Old 40 Years Old 41 Years Old 42 Years Old 43 Years Old 44 Years Old 45 Years Old 46 Years Old 47 Years Old 48 Years Old 49 Years Old 50 Years Old 51 Years Old 52 Years Old 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 OVER 150+ Years Old HISTORIC 150+ YEARS OLD
How Many Acres Do You Own?	Less Than 1/2 Acre 1/2 Acre 3/4 Acre 1 Acre 1.25 1.5 1.75 2 2.25 2.5 2.75 3 3.25 3.5 3.75 4 4.25 4.50 4.75 5 5.25 5.50 5.75 6 6.25 6.50 6.75 7 7.25 7.50 7.75 8 8.25 8.50 8.75 9 9.25 9.50 9.75 10 10.25 10.50 10.75 11 11.25 11.50 11.75 12 12.25 12.50 12.75 13 13.25 13.50 13.75 14 14.50 15 15.50 16 16.50 17 17.50 18 18.50 19 19.50 20 20.50 21 21.50 22 22.50 23 23.50 24 24.50 25 25.50 26 26.50 27 27.50 28 28.50 29 29.50 30 30.50 31 31.50 32 32.50 33 33.50 34 34.50 35 35.50 36 36.50 37 37.50 38 38.50 39 39.50 40 40.50 41 41.50 42 42.50 43 43.50 44 44.50 45 45.50 46 46.50 47 47.50 48 48.50 49 49.50 50 50.50 51 51.50 52 52.50 53 53.50 54 54.50 55 55.50 56 56.50 57 57.50 58 58.50 59 59.50 60 60.50 61 61.50 62 62.50 63 63.50 64 64.50 65 65.50 66 66.50 67 67.50 68 68.50 69 69.50 70 70.50 71 71.50 72 72.50 73 73.50 74 74.50 75 75.50 76 76.50 77 77.50 78 78.50 79 79.50 80 80.50 81 81.50 82 82.50 83 83.50 84 84.50 85 85.50 86 86.50 87 87.50 88 88.50 89 89.50 90 90.50 91 91.50 92 92.50 93 93.50 94 94.50 95 95.50 96 96.50 97 97.50 98 98.50 99 99.50 100 100.50 101 101.50 102 102.50 103 103.50 104 104.50 105 105.50 106 106.50 107 107.50 108 108.50 109 109.50 110 110.50 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 358 359 360 361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 449 450 451-460 460-470 470-480 480-490 490-500 500-510 510-520 520-530 530-540 540-550 550-560 560-570 570-580 580-590 590-600 600-610 610-620 620-630 OVER 630 + ACRES
Bedrooms?	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57
Bathrooms?	1/2 Bathroom 1 Bathroom 1 and 1/2 Bathroom 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Garage Information:	No Garage 1 Car Garage 2 Car Garage 3 Car Garage 4 Car Garage 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
TYPE OF HOME YOU OWN:	FIXER UPPER COMPLETELY REMODELED SOME REMODELING DONE TRAILER DOUBLEWIDE 1 STORY HOME 2 STORY HOME 3 STORY HOME 3+ STORY TOWN HOME RANCHER LOG HOME COMMERCIAL REAL ESTATE (BUSINESS) I LIVE IN A PARK AND PAY ASSOCIATION FEES
ARE YOU?	I'M BUYING A HOME I'M SELLING A HOME I'M BUYING AND SELLING I'M REFINANCING I'M SELLING AND GOING THROUGH A DIVORCE I'M BUYING AND IN THE MILITARY I NEED TO SELL QUICKLY, GET IT SOLD!
Baesment Information:	No Basement Partial Basement Full Basement My Basement Has Mold My Basement Needs Repair My Basement Needs Repair and Has Mold
Landscaping:	Not Landscaped Some Landscaping Fully Landscaping
Any Association Fees?	No associate fees. Yes association fees.
If You Have A Fee How Much A Year?
What Is Your Yearly Property Tax Amount?
THANK-YOU FOR COMPLETING THIS FORM. ANY QUESTIONS YOU MAY HAVE?