FSBO Intake Survey
First Name
Last Name
Email
Phone
Address
City
State
Postal code
Number of Bedrooms
How many full bathrooms do you have? (ex. 1, 2, 3)
0
1
2
3+
How many half bathrooms do you have?
0
1
2+
How many levels? (incl basement)
1
2
3+
Interior Upgrades? (select all that apply)
Fireplace
Garage
Basement
Upgraded Floors (Hardwood/marble/etc)
Upgraded Countertops (Granite/marble/etc)
Theatre room
Sunroom/Bump-out Addition
Entry Level Bedroom
Gourmet Kitchen
Recessed Lights
Wine Cellar
Owner's Suite
Separate Dining Room
Crown/Chair Mouldings
Refrigerator
Stove/Range/Cooktop
Dishwasher
Clothes Washer/Dryer
Exterior Upgrades? (select all that apply)
Shed
Pool
Deck/Patio
Gazebo
Bball/Tennis/etc Court
Fenced Yard
Detached Garage
Lawn Sprinkler System
Senior Living Community
Yes
No
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Waterfront?
Yes
No
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Metro Access Distance
Less than 1 mile
2-5 miles
5+
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Metro Access Type
Metro Bus/Local
Metro Train/Local
Regional Bus
Regional Train
Is there an HOA or Condo Association?
Yes
No
HOA Amount?
$
HOA Frequency?
Monthly
Quarterly
Semi-Annually
Annually
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Does the property have a public sewer connection or septic tank?
Public Sewer
Private Septic Tank
Neighborhood Septic System
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Water: Well or public connection?
Public
Well
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Hot water is fueled by....
Electric
Natural Gas
Propane
Other
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Heat if fueled by....
Electric
Natural Gas
Oil
Propane
Other
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A/C is...
Central A/C
Window units
None
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Neighborhood High School
Neighborhood Elementary School
How Soon Are You Looking to Sell Your Home?
ASAP
1-2 Months
2-3 Months
3+ Months
Motivation for Selling
Seller: After I Sell, I Will Need Help With a....
Purchase
Lease
Neither
Notes
Assign To Agent
Charles Heyward
Jazmyn Heyward
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