Name: First/Last

Address:

Phone Number:

City:

State:

Zip Code:

Home Information-

Current Value of Home:


Year Built:


1 Story 1 1/2 Story 2 Story Bi-Level Tri-Level Other
If Other please specify


Exterior:
Frame Masonry Verneer Masonry Verneer

Basement:
full finished full partial finished full unfinished crawl space slab walkout

Ground Floor Square Footage:


# of Bathrooms:
Full 3/4   1/2

Garage:
1 car   2 car   3 car   Other
Attached   Unattached

Fireplace
Swimming Pool
Trampoline
Daycare

Items to be scheduled:
Jewelry
Collectibles (describe below)

Fine Arts