SMD2 Enterprises, LLC

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Home Seller's Form:

Please complete as much of the requested information below as possible. The more information we have, the better able we are to serve your needs.

ALL Fields must be filled out

First Name:

Last Name:

Email Address:

Work (Day) Phone:

Home (Evening) Phone:

Cell:

Fax:

Property Information:

Address:

City:

State:

Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Postal/Zip:

What are you asking for the house?:

What do you think your house will appraise for if it were in tip-top shape?:

What area is it in?:

Existing Mortgage Information:

What do you owe on the first mortgage?:

Who is the lender?:

Interest rate:

Monthly Payment:

What do you owe on the second mortgage?:

Who is the lender?:

Interest rate:

Monthly Payment:

Are your payments current?:

Yes

No

If behind by how many months or years:

Property Description:

How Many Bedrooms:

1 2 3 4 5 6 7 8

How Many Bathrooms?:

1 2 3 4 5 6 7 8

Square Footage:

Lot Size:

Construction:

Frame

Brick

Block

Stucco

Other

Air Conditioning:

Yes

No

Garage:

Yes

No

Carport:

Yes

No

Basement:

Yes

No

Appliances:

Refrigerator

Range

Dishwasher

Is the house vacant?

Yes

No

Questions

Why are you selling:

Is the house listed?:

Yes

No

How did you arrive at your asking price?:

Does the house need any repairs?:

Approximate Cost?:

When do you want to move?:

Will you sell for what you owe?:

Yes

No

How did you hear about us?:

Questions/Comments:

Important Note: We are part of a network of people in our area that respond to information such as you are submitting and anyone from our group may be calling you. By submitting this information, you acknowledge that you are aware that you will receive follow-up calls and information. We look forward to working with you to achieve your objectives.