Short Sale Information Request Form Please fill out this confidential form and we will get in touch with you right away. Property InformationName* First Last Email* Phone*Best Time to CallMorning 6AM - 9AM ETMorning 9AM - Noon ETAfternoon Noon - 3PM ETAfternoon 3PM - 6 PM ETEvening 6PM - 9PM ETAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Current Estimated value of your Home?How was This Value Determined?Personal EstimateLocal RealtorZillowTruliaRealty TrakOther Loan InformationAre you Behind in Payments?YesNoHow far Behind?1 Month2 Month3 Month4 Month5+ MonthOne or Two Loans?1 Loan2 Loans w/Same Lender2 Loans w/Different LendersMore than 2 LoansPurchase PriceYear Purchased MM DD YYYY 1st Mortgage Holder1st Est. Balance1st Monthly MortgagePayment2nd Mortgage Holder2nd Est. Balance2nd Monthly Mortgage PaymentLoan TypeConventionalFHAVAOtherPMI (Private Mortgage Insurance)YesNoUnknown Foreclosure InformationHave you received your notice of default?YesNoThis 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. Drop files here or Accepted file types: jpg, pdf, doc. Has an auction date been set?YesNoWhen MM DD YYYY How Did you Hear About Us?PostcardLetterRadioFriendGoogleYahooOtherWhen MM DD YYYY Additional InformationThank 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.Captcha*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 Jen True and authorized representatives to contact you even if your name is on the Federal “Do-not-call List.” Page: Short Sale Information Request Form