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
*
Format: (000) 000-0000.
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
Format: (000) 000-0000.
Tell Me About Your Home
Is the home occupied?
Please Select
Yes
No
Name of Financial Institution
Phone Number
Format: (000) 000-0000.
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
Format: (000) 000-0000.
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: