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First name :

Last Name :

Property Address

City State Zip :

Home # :

Cell # :

Property Use :

Lot Size :

Lot Attributes ( View, Traffic, Hills) :

Living Area :

Garage Area :

Year Built :

Bedrooms/ Bathrooms :

Central Heat :

Air Conditioning :

Other Improvements:
(pool, patio, porch, extension)

Property Values:

When was your home last Appraised?

How long have you lived at your current residence?

Do you currently have a mortgage ?

If so, how long is your mortgage?