Please take a few minutes to tell us all about your house and situation. We will review your information and call you to discuss a solution. All information provided will be kept strictly confidential. (See Privacy Policy)

Items marked with a red asterick are required. If you are unable to answer a question, please give us your best guess or enter "?". If you have any problems submitting this form, please call Fred Allen at 321 278-9916.
First Name :
Last Name :
Address of Property :
City :
County :
State :
Zip Code :
Home Phone :
Cell Phone :
Fax :
Email :
How quick do you need to sell your house? :	Immediately One Month Two or more Months
Are you the Owner of Record for this Property? :	Yes No
What is the best time for us to call you? :	Before 9am 9am to Noon Noon to 6pm 6pm to 9pm 9pm to 11pm
Is the Property listed with a Realtor? :	Yes No
Is the Property ..... :	Occupied Vacant
Why are you selling? What is your situation? :
Is the 1st Mortgage payment... :	Current Late No 1st Mortgage
1st Mtg Mo. Payment Amount  :
1st Mortgage Balance :
1st Mtg Interest Rate :
If late, how many months? :
Are your taxes and insurance included in the mtg pmt? :	Yes No Not sure
Is the 2nd Mtg payment... :	Current Late No 2nd Mortgage
2nd Mtg Mo. Payment Amount :
2nd Mortgage Balance  :
2nd Mtg Interest Rate :
If late, how many months? :
Are there any other mortgages or liens? :
What kind of repairs do you think the house needs? :
Will you sell the house for what you owe on it? :	Yes No Undecided
Would you allow us to take over your payments until we resell the house? :	Yes No Undecided
If we paid all cash and could close quickly, what is the least amount you would accept? :
Would you be willing to receive monthly payments for your equity, if any? :	Yes No Undecided
How did you hear about us? :
Do you have any comments or questions you would like to share with us? :
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If you do not hear from us within three business days, please call Fred Allen at 321 278-9916