What is the Current Value of Your Home?
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Would you like to sell your home within the next 6 months?
0-3 months
3-6 months
6-9 months
9-12 months
Undecided
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Are your plans to sell definite at this time?
Yes
No
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Are you currently working with a Real Estate Agent?
Yes
No
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Why are you selling your home at this time?
Upgrading Home/Neighborhood
Closer to Work/School
Job Relocation
Family Change
Retirement
Downsizing
Other
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Please provide some details about your home. Information to include number of bedrooms, bathrooms, basement, garage, special features/upgrades.
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What is the condition of your home?
Poor
Average
Good
Excellent
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Your Address:
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Your Name:
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Your Email:
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Your Phone Number: