Please fill out as completely as possible. All information is confidential.
Name :
Email :
Home Phone :
Work/Cell Phone :
Property Address :
City :
State :
Zip :
Approximate square footage? :
Property type? :
--Select--
Single family
Multi Family
Condo
Commercial
Other
How many bedrooms and bathrooms? :
Are there any loans outstanding? :
Yes
No
What are the balances? :
Are the loans current? :
Yes
No
If late, how many months? :
What is the current mortgage payment(s)? :
Does the house need repair? :
Yes
No
Please describe what repairs are needed :
Year Acquired :
Is the house vacant or occupied? :
Vacant
Occupied
How soon do you want to sell? :
Est. Value of home :
Source of Value :
--Select--
Appraisal
Realtor CMA
Guess
Tax Value
Other
Listed w/Realtor :
--Select--
No
Yes
Why are you selling? :
If I could offer you cash and close quickly, what would be the least you would take? :
How did you hear about us? :
--Select--
Radio
TV
Internet
Billboard
Print Ad
Letter/Postcard
Word of mouth
Other
Additional notes :
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We Buy Houses Fast
Toll Free: 888-565-1413
Direct: 413-241-6859
info@hampdenhomebuyers.com