Property Street Address
Property City
Resident Status
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Primary Residence
Secondary Residence
Vacation Home
Rental
Year Built
Property Type
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Single Family
Multi Family
Town House
Manufactured Home
Other
Number of Stories
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Single Story
Two Story
Split Foyer
Split Level
Square Footage
Lot/Acreage Size
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1/3 Acre
1/2 Acre
1 Acre
2-5 Acres
5-10 Acres
10+ Acres
Number of Bedrooms
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1
2
3
4
5
5+
Number of Bathrooms
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1
1.5
2
2.5
3
3.5
4
4+
Type Of Heating
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Propane Forced Air
Electric Forced Air
Natural Gas Forced Air
Solar
Electric
Heat Pump
Radiant
Wall Electric
Natural Gas Steam
Oil
Other
Central Air
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Yes
No
Basement
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None
Unfinished
Partially Finished
Finished
Parking
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On Street
Off Street
Other
Garage
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1 car
2 cars
3+ cars
None
What is the condition
of your home?
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Fair
Good
Excellent
Is your home currently listed
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Yes By Agent
Yes By Owner
No
When do you plan to sell
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Immediately
Within 90 Days
Within 6 months
Within 1 Year
Upgrades and
special features
Potential issues
with your home
Name
Address 1
Address 2
City
State
Zip
Phone
Fax
E-mail
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