Sales Verification Questionnaire

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Total Sales Price?*

Date of Purchase?*

Was any trade of real estate, fixtures, equipment, merchandise or other personal property included in this sale? Yes No

If yes, what type of property?

Estimate of value

Was any financing assumed from the prior owner? Yes No

If yes, what was the amount?

Was this sale between relatives? Yes No

Was this a forced sale by court order, divorce, or foreclosure to settle an estate, etc. ? Yes No

Do you consider the sale price to be the market value of the real estate on the date of the sale? Yes No

If no, why?

If this is rental property, what is the monthly rent?

Gross Rent (landlord pays bills) Net Rent (tenant pays bills)

What is the present use of this property?

If this property is a single family residential, please answer the following related questions.

Year Built

Square ft. of Heated/Cooled Area

Number of Baths

Type of Heating/Cooling

Number of Bedrooms

Number & Type of Fireplaces

Insulation Ceilings Walls Floors

Roof Covering

Floor Covering

Condition at time of purchase

Street Address of Property

Property Owner

Telephone # (optional)