Your Name

Your Phone Number

Email Address:

Fax Number:

What is your mailing address?

Address

City

State

ZIP

Do you own your home, rent, or is it vacant?

Please Choose ----------------------- Own Rent Vacant

How long have you owned this property?

Please Choose ----------------------- Less than 1 year 1 - 3 Years 3 - 5 Years 5 - 10 Years 10 - 20 Years Longer than 20 years

How did you hear about us?

Please Choose ----------------------- Google Search Yahoo! Search WRAL.com Realtor.com The Real Estate Book Sold Sign Martha's Website The Pilot Seven Lakes Times Home Buyers Channel Post Card Referral Other

How many bedrooms?

Please Choose ----------------------- 1 Bedroom 2 Bedrooms 3 Bedrooms 4 Bedrooms 5 Bedrooms 6 Bedrooms 7 or More Bedrooms

How many bathrooms?

Please Choose ----------------------- 1 Bathroom 2 Bathrooms 3 Bathrooms 4 Bathrooms 5 Bathrooms 6 Bathrooms 7 or More Bathrooms

What type of exterior siding do you have?

Please Choose ----------------------- Aluminum Brick Stone Vinyl Wood Shingle Stucco Combination HardiPlank Other

What type of heating system do you have?

Please Choose ----------------------- Electric Radiant Heat (in the ceiling) Electric Baseboard Heat Fuel Oil Furnace Electric Forced Air Gas Forced Air Wood Stove Fireplace Other

What type of air conditioning do you have?

Please Choose ----------------------- Central Air Heat Pump Window Air Wall Unit Air Attic Fan Other

What type of garage do you have?

Please Choose ----------------------- 1 Car 1 1/2 Car 2 Car 2 1/2 Car 3 Car 3 1/2 Car 4 Car or Larger None

How many square feet do you have?

Please Choose ----------------------- Under 1000 Square Feet 1000 - 1500 Square Feet 1500 - 2000 Square Feet 2000 - 2500 Square Feet 2500 - 3000 Square Feet 3000 or More

Have you had the home appraised in the last 5 years?

 Yes   |   No

What is the approximate price of your home?

Tell us about any special features about your
home that are important to you:

When is the best time for Martha to meet with you?

Tell us about any recent improvements or updates that you think will help your home resale: