Home Ownership Contact Form

Name

Email Address

Phone Number

Business Phone

Cellular or Pager

Address

City

State

Zip

Are you buying or selling a home?
Choose One buying selling

Property address

City

County

State

Are you working with or through a real estate broker or other professional?
Yes  No 

If so, please provide his or her name

Company name

Address

City

State

Zip

E-mail address

Phone

Have you had the property inspected or appraised?
Yes  No 

If so, state the appraiser or inspector's name

Company name

Address

City

State

Zip

E-mail address

Phone

Is the property farm property?
Yes  No 

Vacation property?
Yes  No 

New construction?
Yes  No 

Are you aware of any issues regarding the condition of the property?
Yes  No 

If so, please describe those issues

Are you aware of any issues regarding the ownership of the property (such as, other claims of ownership, mechanic's or other liens, boundary issues)?
Yes  No 

If so, please describe those issues

How did you out about find us?

If somebody referred you to us, who was it?

Special concerns

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