LG Realtor Seller Intake Form
Turning Dreams Into Addresses
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Are you Married?
*
Please Select
Yes
No
If Married, is there joint ownership?
*
Please Select
Yes
No
Spouse Name
First Name
Last Name
Spouse Email
example@example.com
Spouse Address (If Different from above)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Tell Me About Your Home
Is the home occupied?
Please Select
Yes
No
Name of Financial Institution
Phone Number
Address of Financial Institution
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Account Number
Balance Owed
Is there a second mortgage on the home?
Please Select
Yes
No
Name of Financial Institution
Phone Number
Address of Financial Institution
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Account Number
Balance Owed
HOA?
Please Select
Yes
No
Monthly Amount
Annual Amount
Specify Style of Home
Single occupancy house
Apartment/Loft
Flat
Ranch Style
Bungalow
Split Level
Duplex
Other
Square Footage
*
Number of Bedrooms
*
Number of Bathrooms
*
Fireplace?
*
Please Select
Yes
No
Garage?
*
Please Select
Yes
No
Garage Type
*
Please Select
Attached
Detached
Spaces?
*
Please Select
1
2
3
Basement
Full
Partial
Walkout
Finished
Unfinished
Slab
Sump Pump
Sump Pump/Pit
Notes/Updates/Issues - Anything that impacts salability:
Submit
Should be Empty: