Multi step Address Form
"
*
" indicates required fields
1
Personal information
2
Contact Information
3
Property Information
4
Additional Information
5
Your Situation
Contact Us
Want Your Offer Faster? Just Give Us A Call At:
(123) 456-7890
What's your name?
Name
*
Contact Us
Want Your Offer Faster? Just Give Us A Call At:
(123) 456-7890
Please provide your contact info.
Phone Number
*
Email Address
*
Contact Us
Want Your Offer Faster? Just Give Us A Call At:
(123) 456-7890
Property Information
Address
*
Street Address
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Contact Us
Want Your Offer Faster? Just Give Us A Call At:
(123) 456-7890
What best describes why you want to sell? (Select all that apply)
*
Foreclosure
Inheritance
Divorce
Structural/Fire/Water damage
Tired Landlord or Non-performing tenants
Sell without real estate agent
Emergency reasons
Relocating
How long have you owned the property?
*
0-5 years
5-15 years
15-30 years
30+ years
What kind of repairs and maintenance does the house need?
*
Full Gut - Everything
Remodel - Kitchen, Bathrooms, Roof
Cosmetic - Flooring, Paint
None - TV Commercial Ready
Is there anyone living in the house?
*
Yes
No
Contact Us
Want Your Offer Faster? Just Give Us A Call At:
(123) 456-7890
When do you want to sell?
*
ASAP
Within 30 Days
Within 60 Days
Within 90 Days
No Timeline
If we offered CASH, paid all the closing costs & fees, and closed at your convenience, what's the lowest acceptable offer you would consider?
*
When is the best time to call you?
*