Name
Address
City|State
Day Phone
Night Phone
E-Mail
Comments
Are you looking to evaluate your home's value for the purpose of selling or refinancing? Selling or Refinancing
If you are planning to sell your home, will it be within the next six months?
Yes , No
Style of home you wish to sell
 Type of home ( i.e. detached)
Approximate square footage
 Location of home
Type of heating
 Age of home
Number of bedrooms
 Number of bathrooms
Fireplaces
 Finished Basement
On a scale of 1-10 rate the showability of your home
(Poor 1 -----10 Exceptional)