How can we help you?:	select want quick cash sale broken chain-lost buyer sell inherited property moving abroad divorce financial problems facing eviction other
Title:	select Mr Mrs Miss
First Name:
Last Name:
Email Address:
Landline Number:
Mobile Number:
Best time to contact you?:
Address:
Town:
Postcode:

Type of Property:	select apartment/flat maisonette mid-terrace end-terrace semi-detached link-detached detached bungalow semi-detached bungalow detached
Number of Bedrooms:
Is the property on the market?:	select Yes No
Name of Estate Agent:
Condition of the Property:	select Excellent Good Average Below Average Poor
Does it need decorating?:	select Yes No

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Outstanding mortgage amount:
Outstanding amount of any other loans secured against the property:
What is your estimate of your property's current market value?: (please enter value without using any spaces or commas)
How did you arrive at this figure?:
How quickly do you want to sell?:	select Urgent-Need to sell ASAP Within 1 month 1-2 months
What is your asking price for your property?:
What is the minimum price that you are willing to accept for your property?:
Any other information you would like to tell us?: