Short Sales Information Request Form

Home Owner Request Form

An asterisk * indicates a required Field

Property Information
First Name*:
Last Name*:
Best Time to Call*:
Property Address 1:
Property Address 2:
I am:
Current Estimated value of your Home?
How was This Value Determined?
Loan Information
Are you Behind in Payments? YesNo
How far Behind?
One or Two Loans?
Purchase Price:
Year Purchased:
1st Mortgage Holder:
1st Est. Balance:
1st Monthly Mortgage Payment:
2nd Mortgage Holder:
2nd Est. Balance:
2nd Monthly Mortgage Payment:
Loan Type: ConventionalFHAVAOther
PMI (Private Mortgage Insurance: YesNoUnknown
Foreclosure Information
Have you received your notice of default?* YesNo
This is the letter stating the bank has sent your file to a lawyer to start the foreclosure process. It would have been delivered via USPS Certified mail.
Has an auction date been set? YesNo
If Yes, When?
How Did you Hear About Us?*
If Yes, When?
Additional Information

Thank you for your effort to provide us with accurate information. We will Contact you within 24-36 hours. A copy of this information will be sent to via email when click submit.

Type the characters you see into the area above

*Your name and email address are required, so please be sure your email address is entered accurately. By submitting this form with your telephone number you are consenting for Rayford & Company and authorized representatives to contact you even if your name is on the Federal "Do-not-call List."

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