Short Sale Request Form You may qualify to have your lender(s) pay for the sale of your home or condo. For a free evaluation please fill out this Short Sale Request form. Name* First Last Email* Phone* Property Ownership:* Primary ResidenceInvestment Property Property Address (Number and Street Name):* City, State and Zip Code:* 1st Lender Name:* Is this an FHA or VA Loan?* If yes, which? Approximate loan balance on 1st loan only?* 2nd Lender Name (If applicable) Approximate loan balance on 2nd? 3rd Lender Name (If applicable) Other liens or loans on the property? Combined balance of 3rd/other loans/liens? Do you have a foreclosure sale date?* If yes, what date? Do you have mortgage insurance?* Have you discussed your options with your lender? Such as loan modification, short sale, or other?* Have you spoken to another real estate agent about selling your home?* Please tell us anything else you would like us to know: Phone This field is for validation purposes and should be left unchanged.