Realtor Representative Full Name: *

First Name

Last Name

Realtor Representative Phone *

(###)

###

####

Subject Property Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Hong Long Has the Owner Lived in the House? *

6 Months to 1 Year

1 Year to 3 Years

3 Years to 5 Years

5 Years to 10 Years

10 Years or Greater

Comps Pulled and Included? *

Yes

No

Does the house have a garage? *

Attached

Detached

No Garage

Other

Any Structural or Mechanical Issues? *

Roof

Plumbing

Electrical

HVAC (Air & Heating)

Termites

Foundation

Mold

Fire

Flood

Pool Pump

Hot Water Heater

None

Are You Currently In Any Of These Situations? *

Past Due 30 to 90 Days

Pre Foreclosure

Loan Modification

Divorce

Inherited Property

Frustrated Landlord

Probate

Estate Sale

Out of State Landlord

Liquidate Property

Bankruptcy

Other

Would you like to know your best options?

Yes

No

Will the seller allow SVI to visit the property and validate repairs? *

Yes

No