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Stop Foreclosure Following is our FAST  response form.  Fill out this form as completely as possible and we will promptly contact you to discuss your options. The information you provide on this form will remain confidential Hint: When filling out online forms you can use your "tab" key to easily move from field to field. Tell us about you... Your name: E-mail address: Daytime phone: Evening phone: Best time to call: Tell us about the property... Property street address: Property city and state: The Property is currently: Owner Occupied Occupied by Renter Vacant No. of Bedrooms: 1 2 3 4 5 6+ No. of Baths: 1 1.5 2 2.5 3 3.5 4+ Square footage: Age of House: Garage: Please Select One Car Attached One Car Detached Two Car Attached Two Car Detached Carport None Other What is the general condition of the house: Please Choose Excellent Good Fair Poor UGLY! Please describe any needed repairs in this box Check all that apply Wood Floors Formal Dining Room Carpeting Game Room Tile Fireplace Finished Basement Deck Unfinished Basement Swimming Pool Privacy Fence Other Fence Brick Vinyl Siding Steel Siding Wood Siding Other Siding Stucco Central Heat Central Air Floor Furnace Wood Stove Septic Tank   Crawl Space Slab Storage Shed Shop Tell us about the numbers... How much do you feel the property is worth: 1st mortgage balance:  1st mortgage payment amount: Does the 1st mortgage payment include taxes and insurance: Select Yes No Are there other mortgages on the property: Select Yes No What is the combined balance of all mortgages: What is the combined monthly payment on all mortgages: Please tell us about any other liens and/or other title problems that may affect this property by typing an explanation here. Are all mortgage payments current: If payments are current click here Select Yes No If payments are not current, how far behind are they? 1st mortgage $ Amount behind # of payments 2nd mortgage $ Amount behind # of payments Other mortgage $ Amount behind # of payments Have you received a foreclosure notice: Select Yes No Has a foreclosure sale date been set: Select Yes No Sale date: Just a couple more questions... Is your property currently listed with a real estate agent/broker: Select Yes No If property "is" listed, when does your listing expire: Are you currently in bankruptcy: Please Select No Yes - Chapter 7 Yes - Chapter 13 How did you hear about us: Referral from Attorney Referral from CPA Referral from Friend Referral from Realtor Newspaper Postcard Letter Internet search engine Link from other Internet site Other Please provide any further comments that you feel are important in the box below...