Your Real Estate Expert - Paul Galiszewski - The Galis Group

Short Sale Contact Application 

Please fill out the form below.  Your information is secure and will not be shared by any third-party sources.  Please make sure to fill out all the required fields.  Once you submit the pre-application, we will contact you to arrange a time to meet.  If you have any questions, feel free to contact us by clicking here

Short Sale Contact			Required
Contact Information
First Name
Last Name
Email Address
Phone Number
Best time to contact you
Street #		Street Name
Suite #
City		Zip/Postal Code
PO Box
State/Province		Country
Social Security
Property Information
Property Type
Mortgage Company
Loan Number
Second Mortgage Company
Second Mortgage Loan Number
Bedrooms	Select one12345+
Bathrooms	Select one1234+
Age Range of House	Select one0-910-1920-2930-3940+
Garage
Basement	UnknownNonePartialFull
Heating	Select oneCentralWallNoneOther
Air Conditioning	UnknownCentralWallNoneOther
Features Enter a feature and click "Add". Up to 15 features can be entered.
Current Value?
Questions
When are you planning to move?	Select oneImmediatelyWithin 3 monthsWithin 6 monthsWithin a yearUndecided
Are you currently working with a Realtor?	Yes    No
Do you need assistance in finding a new home?	Yes    No
Would you like more information on financing?	Yes    No
Additional Comments?
Currently Owe
Currently In Default?
Declared Bankruptcy
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