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Please fill out the following information to receive your free home value assessment. The more accurately you complete the form, the more accurate your assessment will be. Please double check your answers before submitting.

* Name (First AND Last): * Address (number and street): Address2 (optional): * City, State Zip: , Alberta Alaska Alabama Arkanasas Arizona British Columbia California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentuky Louisiana Massachusetes Manitoba Maryland Maine Minnesota Missouri Minnesota Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jeresy New Mexico Nevada New York Ohio Oklahoma Ontario Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virgin Islands Vermont Virginia Washington Wisconsin West Virginia Wyoming * Email Address: * Phone Number:

Please complete to the best of your ability. The fields marked with an asterisk are required to process this form. Please keep in mind that the more information we receive the more accurate your assessment will be.

* Listing Status:	Required Not Listed For Sale By Owner Listed with an Agent	* Planning to Sell:	Required Under 30 days 30 - 60 days 60 - 90 days Within 6 months Within 1 year Not Planning
Resident Status:	Primary Residence Secondary Residence Vacation Home Rental/Investment Property	Property Relationship:	Owner Potential Buyer Other
Property Type:	Single Family Home Condo Land Farm Co-op Townhouse Mobile Home	Condition of Property:	Perfect Great Ok Worn Poor
LotSize:	under 1/4 acre 1/4 - 1/2 acre 1/2 and 1 acre 1 - 2 acres 2 - 5 acres over 5 acres	Living Area:	under 1000 sqft 1000-1500 sqft 1500-2000 sqft 2000-2500 sqft 2500-3000 sqft 3000-3500 sqft 3500-4000 sqft 4000-4500 sqft 4500-6000 sqft 6000-7500 sqft over 7500 sqft I don't know
Basement:	None Finished Unfinished Patially Finished	Year Built:	Since 2000 1995-1999 1990-1994 1985-1989 1985-1989 1970-1979 1950-1969 1930-1949 1900-1929 1800-1899
Number of Bedrooms:	1 2 3 4 5 6 7 8 9 10	Number of Bathrooms:	1 1 1/2 2 2 1/2 3 3 1/2 4 4 1/2 5
Parking:	1 Car Garage 2 Car Garage 3 Car Garage Carport Street Valet None

This service may not be available in all areas. A licensed local real estate agent may contact you for additional information to help you estimate your home's value. This service is designed to assist you in determining your home's value for purposes of helping you decide to list your home. This estimate will be based on recent sales and/or listings of similar homes in your area. This estimate is not intended to be, nor should it be, relied on as an appraisal by a licensed, professional appraiser or a Comparative Market Analysis conducted by a real estate agent. Always consult a licensed local real estate agent before contemplating any real estate transaction.

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