How can we help you?:	select want quick cash sale broken chain-lost buyer sell and rent back sell inherited property moving abroad divorce financial problems facing eviction other
Title:	select Mr Mrs Miss
First Name:
Last Name:
Email Address:
Daytime Contact Number:
Alternative Contact Number:
Best time to contact you?:

Address Line 1:
Address Line 2:
Town:
County:
Postcode:
Type of Property:	select apartment/flat maisonette mid-terrace end-terrace semi-detached link-detached detached bungalow semi-detached bungalow detached
Number of Bedrooms:
Is there a garage?:	select Yes-single garage Yes-double garage No garage
Is there off-road parking?:	select Yes No
Is the property on the market?:	select Yes No
Name of Estate Agent:
Condition of the Property:	select Excellent Good Average Below Average Poor
Does it need a new kitchen?:	select Yes No
Does it need a new bathroom?:	select Yes No
Does it need central heating?:	select Yes No
Does it need re-wiring?:	select Yes No
Does it need new windows?:	select Yes No
Does it need decorating?:	select Yes No
Does it need new carpets?:	select Yes No

Outstanding mortgage amount:
Outstanding amount of any other loans secured against the property:
What is your estimate of your property's current market value?: (please enter value without using any spaces or commas)
How did you arrive at this figure?:
How quickly do you want to sell?:	select Urgent-Need to sell ASAP Within 1 month 1-2 months
Would you like the option to rent the property back after selling to us?:	select Yes No
Based upon your estimate above that your property's market value is £, are you willing to consider without obligation a guaranteed cash offer of up to £ (75% of market value) for a quick sale?:	select Yes No
What is the minimum price that you are willing to accept for your property?:
Any other information you would like to tell us?: