Personal Information to value your home
Name:
Contact Address:
City:
State / Zip:	AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
Day Evening Mobile Phone:
Day Evening Mobile Phone:
Email: (Your Privacy will be protected)
Please Note: If you do not supply us with an email address, we will be unable to send you any information.
Home Information For Evaluation
Address of Property to be Evaluated:
Subdivision:
City:
Year Built:
How long have you owned this home:
Square Footage:
Number of Bedrooms:	select one 1 2 3 4 5 6 or more
Number of Bathrooms:	select one 1 1.5 2 2.5 3 3.5 4 or more
How much did you pay for this home:
What price do you hope the market will give you:
Property Type:	select one Single family home Townhome or Condo Single story Two Story Estate Home
Garage:	select one None 1-Car 2-Car 3-Car 4-Car Carport
Home's Overall Condition:	select one Poor Fair Good Very Good Excellent
Have you made any major improvements to your home?	Yes   No
Upgrades and Amenities:
Additional Information
Market Analysis Purpose:	select one Refinancing Tax Evaluation Planning to Sell
Do you plan to Refinance?	Yes   No
Property Tax Comparison:	Yes   No
Do you plan to sell your home?	select one No 0-3 Months 3-6 Months 6-12 Months More than 1 year
Do you plan to sell your home yourself?	Yes   No
Are you working with a Realtor?	Yes   No
Are you relocating?	Yes   No
Do you need help finding a new home?	Yes   No
Are you buying locally?	Yes   No