FORM | Second Chance

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Foreclosure Questionnaire

First name

Last name

Email

Phone

Multi-line address

Country/Region

Address

City

Zip / Postal code

Is this property owner-occupied or an investment property?

Who is your lender?

Approximate loan balance owed ($)

What do you believe your property is worth today ($)

How far behind are you on payments?

1 - 3 Months

3 - 6 Months

6 - 12 Months

Over 12 Months

Monthly mortgage payment ($)

Monthly Property taxes ($)

Monthly Insurance ($)

Has foreclosure already started?

Yes

No

Not Sure

How soon do you need to sell?

ASAP

Within 30 days

30 - 60 days

Just exploring options

What is the reason you got behind and why are you currently in foreclosure?

1019 Hyland Dr,Evergreen, CO 80439, United States

Tel: 720-498-2736

Fax: 210-817-3790

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