Your Contact Information  (Please complete all fields)   First Name: Last Name: Daytime Phone: Evening Phone: (If different from daytime) Fax: (If available)   Email: (Double check for accuracy) Street Address: City: Province: Postal Code:

Are you looking to evaluate your homes value for the purposes of selling or refinancing?     Selling Refinancing If you are planning to sell your home, will it be within the next 6 months?     Yes No

Are you currently working with a real estate sales representative or broker? Yes No

Description of the home you wish to sell:

Style of Home:  (Example. Bungalow, 2 storey, Sidesplit, Backsplit, etc.)   Type of Home   Detached Semi-detached Link Townhouse-Freehold Townhouse-Condo Condo Other Select from list Approximate Square Footage:   Lot Size: ft. Frontage x  ft. Depth Garage:   No Single Attached Single Detached Double Attached Double Detached Triple Attached Triple Detached Other described in comments below Select from list Type of Heating:   GAS OIL ELECTRIC OTHER Select from list Propane Comination - Describe in comment section below. Age of Home:   Number of Bedrooms:   Select from list 1 2 3 4 5 More Number of Bathrooms:   Select from list 1 1.5 2 2.5 3 3.5 4 5+ Fireplaces:   YES NO MULTIPLE Select from list Basement:   Select from list No Basement Unfinished Partially Finished Fully Finished  Waterfront:   NO Yes Select from list Pool:   NO Above Ground Inground Select from list On a scale of 1-10 (with 1 being Poor and 10 being Exceptional), please rate the show ability of your home: Poor 1 10 Exceptional   Use this box to describe any special features and other comments about your home: (Hardwood flooring?  Kitchen renovated?  New roof?  New Furnace?  Newer Windows?  Central Air?)