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Company:
Phone	Fax   Email
Preferred Method of Contact	Phone Fax  Email
Property Owner Name
Property Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
County
Subdivision Name
Lot Size	X
PIN#
House Style	1-1/2 Story 2 Story Bungalow Cape Cod Condo Country Dutch Colonial English Tudor French Colonial Georgian Ranch Raised Ranch Saltbox or Garrison Southern Colonial Spanish Colonial Split Level Townhouse OTHER
If "Other" Please Specify
Construction	Brick Frame Siding Stucco OTHER
If "Other" Please Specify
Year Built or Approximate Age
Gross Living Area (sq. ft.)
Total Number of Rooms	NOTE:  DO NOT INCLUDE BASEMENT
Number of Bedrooms
Number of Bathrooms
Central Air?	Yes No
Fireplace?	Yes No
Any Additional Features? (Check all that apply)	Deck Patio Fenced In Yard Enclosed Porch In Ground Pool OTHER
If "Other" Please Specify
Basement?	Yes No
Basement Type	Full Partial Finished Unfinished Walkout OTHER
Comments
Basement Finish Includes? (Check all that apply)	None Family Room Rec Room Bathroom Bedroom OTHER
Comments
Crawl or Slab?	None Crawl Slab
Garage?	Yes No
Number of Stalls
Please list any recent updates to the property
Has this property sold within the last four (4) years?	Yes No
Is this property listed with MLS?	Yes No
If "Yes", list price	and MLS ID#
Estimated Value of Property
Type of Financing	Conventional FHA OTHER
If "Other" Please Specify
What year was property purchased?	Amount paid?
If there are questions regarding the information, name of person to contact	Telephone
Any additional comments or information?

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