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Last Name

First Name

Email Address

Phone Number

Property Parcel Number

Property County/State

What utilities are on the property?
Water - Mainline adjacent to the propertyWater - Water meter onsitePowerSewerSeptic/Perc-testedNoneUnknown

What do you think your property is worth?

Do you own the property?
YesNo

Why are you selling the property?

Is the property part of an HOA?
YesNoUnknown

If so, what are the annual dues?

Did you receive a letter in the mail?
YesNo

If so, what is the 6-digit number in lower left hand corner of the letter?

Any additional info about the property?

5+4=