Short Sale Intake Form
( *=required fields )
Homeowner Info:
Full Name:*
Property Address:*
Phone Number:
*
Cell Number:
E-mail Address:
*
Property Info:
Sq Ft.:
Beds:
Baths:
Garage:
Pool:
Stories:
Is this Primary Residence?:
*
Yes
No
Is this Property Occupied?:*
Yes
No
Does the Propoerty Need Major Repair?:*
Yes
No
Lender Info:
1st Lender Name:*
Amount Owed (1st):*
2nd Lender Name (if applicable):*
Amount Owed (2nd):*
Other Liens or Lenders?:*
Yes
No
If Yes, Describe:*
# of Payments Behind
:*
Why are you behind? (divorce, job loss, etc.)*
Has a Trustee’s Sale been noticed?:
*
Yes
No
If yes, Date of Sale?*
HOA Info:
Is there an HOA?:
Yes
No
Is the HOA Current?:
Yes
No
HOA FEES (per month/per quarter?)
HOA Name
:
HOA Phone:
Is property presently listed for sale with a Realtor?
Yes
No
If So, please provide Name
:
And Phone:
Have you applied for a forbearance or loan modification in the past two years?
Yes
No
If so, when and what was the result:
*Legal Disclaimer: I understand that by submitting my property information, I am submitting my information solely for the purpose of a free evaluation of my property as a potential short sale prospect. I understand and agree that no contractual relationship of any kind is being created, and that ImUpsideDown.com and its representatives have no legal duties/obligations to me. I understand that a contractual relationship will
only
be formed if and when the following occur:
(1)
I am notified that my property satisfies the guidelines of ImUpsideDown.com as a potential short sale;
(2)
I agree to participate in the short sale program;
(3)
I submit necessary paperwork requested by ImUpsideDown.com representatives; and
(4)
I sign all agreements/documents required by ImUpsideDown.com representatives to commence work on my short sale.
Yes
No
