MIAMI OFFICE

9425 Sunset Drive, Suite 124
Miami, FL 33173
Tel.: (305) 271-0100 x701
Fax.: (305) 777-8816
Toll Free: (877) 900-0036
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Short Sale Request

* Required Fields

*Your Name:
*Your Email:
*Your contact phone number:
*Your role: owner/seller  realtor  family member/friend  other 
Current property owner(s):
Property address: Unit #:
City: *State: Zip:
*Original purchase price:
Is this the homestead or primary residence of the owner? Yes  No 
*Property condition: excellent  good  fair  poor  needs repairs
  condemned or un-inhabitable 
*Estimated current market value in as-is condition:
Not sure of estimated market value? Try these links:
www.zillow.com
www.realestate.yahoo.com/Homevalues.com
*Has the property been listed with a realtor? Yes  No 
If yes, length of time on the market:
*Is the property currently under sales contract? Yes  No 
*If yes, what is the contract sales price?
Is the contract assignable? Yes  No 
*Realtor commission:
Not Applicable
*Is the buyer/investor paying cash? Yes  No 
If no, % financed by the buyer:
Scheduled Closing Date:

Amount of mortgages/ loans on property:

Lender(s) Estimated
Payoff
Amount(s)		 Payment Status
15-30 days late  30-90 days late
  90 + days late  not late 
15-30 days late  30-90 days late
  90 + days late  not late 
15-30 days late  30-90 days late
  90 + days late  not late 
*Do any of the above referenced loan(s)
carry PMI (Primary Mortgage Insurance)?		 Yes  No 
*Does the main bank escrow for taxes and insurance? Yes  No 
*Are property taxes past due on the property? Yes  No 

Please list any other liens, judgments, code violations, code enforcement, child support past due, federal tax liens or other obligations that would be have to be paid at closing?

Owed to Amount due
*After all mortgages and debts are paid off, how much is the owner
estimated to receive in his/her pocket after closing?

Additional questions:

1. Has there been a catastrophic illness, accident or injury
affecting the borrowers ability to pay the loan(s)		 Yes  No 
2. Has there been a death in the family
affecting the borrower's ability to pay?		 Yes  No 
3. Has the borrower been recently been unemployed? Yes  No 
4. Has borrower been recently relocated by their employer? Yes  No 
5. Has the borrower been called away to active military duty? Yes  No 
6. Has the borrower become financially insolvent and
has no realistic expectation of repaying loan(s)?		 Yes  No 
7. Is the borrower incarcerated? Yes  No 
Addtional comments:

We will contact you within 1 business day for an assessment of whether your property could be eligible for short sale consideration by your lender(s).