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Your Name

Your Email

Phone Number

Address or major intersection

Age of Home

Approximate Square Footage

Number of Bedrooms

Number of Bathrooms

Approximate Lot Size

Ownership of Home
Free HoldCondominium

Type of Home
Single detachedSemi-detachedTown homeApartment

Other Type:

Style of Home
bungalowtwo storysplit level

Other Style:

Garage
nonesingle cartwo carthree +Car port

Finished Basement?
YesNoPartially

Other Basement:

Condition of Home:
GreatAveragePoor

Other Condition:

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