Your Name(s): (Provide your name as it appears on your driver's license)

Property Address: (Address, City, State & Zip)

Phone: (Please indicate Cell, Home or Work phone)

E-mail: (E-mail address that you check on a daily basis)

Is your property currently listed with another Realtor?  (Answer Yes or No.  If Yes, please explain, for example: Yes, but I'm not happy with my Realtor and my listing agreement ends at the end of this month.)

Is the property your inquiring about for the short sale your primary residence or income property?

If it's an income property, what is your total gross monthly rental income?  (If not rental property, write "N/A.")

Number of bedrooms, bathrooms, size? (ex: 3br / 2ba / 1,500 sf)

Does your house have a built-in pool and/or spa? (Answer Yes or No.  For example: Yes, we have a pool, but no spa.)

When was the property purchased? (ex: November 10, 2006)

Original purchase price? (ex: 250,000)

How did you obtain the property, as a traditional purchase or was it transferred to you by a family member? (ex: "I purchased the property."  Or, "My parents transferred the property to me.")

Who is on title? Please list ALL parties. (ex: John Doe, Sue Doe, Bob Doe)

Who is on the mortgage?  Please list ALL parties. (ex: John Doe, Sue Doe)

What kind of mortgage do you have?  (ex: Conventional, VA, FHA, etc.)

Who is the lender(s)?  List ALL lenders.  (ex: 1st - Bank of America, 2nd - Ocwen Loan Servicing, 3rd - Key Bank)

Are your loans purchase money loans or refinance loans?

All purchase money loans - The original loans that you used to buy your house.

Some purchase money loans and some refinance loans.

Refinance loans - Loans that your refinanced into to get cash out or get a better rate (not the original loans you used to purchase the property).

Approximately what are your mortgage balances? (ex: 1st mtg - $300k, 2nd mtg - $100k, 3rd mtg - $25k)

What is the total gross monthly income of all borrowers?

What is the total monthly net income (take home pay) of all borrowers?

Ballpark, how much liquid assets (checking, savings, money market, stocks, etc.), excluding retirement (401k, IRA, etc.), do you have?

What is the total monthly principal, interest, property tax and insurance monthly payment (PITI)?  Please include all mortgages on your home.

What is the total monthly household expenses other than PITI?  (ex: car loan, car insurance, car gas, care maintenance, minimum credit card payments, student loans, child care, alimony/child support, entertainment, house maintenance, utilities, etc.  See preliminary financial worksheet for help, click here.)

Are you living in the short sale property or is it occupied by a renter?  If you are not living in the property, where are you living and is the short sale property being maintained? (ex: Property is vacant.  We live with our parents now.  We are taking care of the landscape on a weekly basis.)

What is the condition of the property?  What repairs are needed? (ex: Fair condition.  Needs paint and new carpets.)

If you are relocating, when do you have to move and why?  (If not applicable, enter N/A)

 Please provide condo/HOA contact information?  (Name of HOA, address and phone number.  If not applicable, enter N/A)

Are you current on your HOA dues?  If not, are there any HOA liens on your property? (Answer yes or no.  If yes, describe lien and approximate amount owed.)

Are you current on your property taxes and/or utilities?  (Answer Yes or No.  If Yes, please describe lien(s) and approximate amount owned for each lien(s).)

Are there other liens on your property? (Answer Yes or No.  If Yes, please describe lien(s) and approximate amount owned for each lien(s).)

Have you considered or are you currently attempting a loan modification? (For example: Yes, I'm considering; Yes, I'm currently attempting a loan modification; No, I haven't considered.)

Have you considered or are you considering declaring bankruptcy?  (Answer Yes or No.  For example: Yes, I'm considering; Yes, I'm currently in bankruptcy; No, I haven't considered.)

Are you current on all your mortgage payments and will you be able to remain current?  

If you are NOT current, when did you make your last mortgage payment? (ex: 1st - current, 2nd - made last mortgage payment 7/1/2009, 3rd - made last mortgage payment 6/1/2009)  If not applicable, enter N/A.

If you are NOT current on your mortgage(s), have you received "Notice of Default" (usually sent after you're beyond 60-90 days late on your mortgage payments) or "Notice of Trustee Sale" letters (usually sent 60 days after the notice of default letter)?  (If you don't know, then enter "I don't know" or if not applicable write N/A.) 

What situation (hardship) caused you to miss or will cause you to miss your payments, or if no payments have been missed why do you need to sell?

Do you have any IRS or FTB liens? (ex: Yes - $20,000 for unpaid income taxes.  If not applicable, N/A)  

Do you have any judgments against you? (ex: Yes - $5,000 for child support.  If not applicable, N/A)  

Do you hold any kind of security clearance?  Are you employed by government agency or company that requires you to have security clearance to do your job?  (ex: Yes - FBI, CIA, Navy Seal, Boeing Engineer, etc.)