Please Fill Out This Quick Form Regarding Our Short Sale Program.

Property Address**
How many people on Title**
First Name **
Last Name **
Cell **
Phone **
Email **
Marital Status** Single Married Divorced
Other People on Title**
How many Loans**
Lenders & Est. Loan Amounts**
Any Leins or Judgments** Yes No
With Whom & How Much?**
When was your last Payment**
Are you aware of a Sale date** Yes No When**
Are you aware of a Notice of Default?** Yes No When**
Have you ever applied for a loan mod ** Yes No
Was it approved** Yes No When**
Have you ever Filed for a Bankruptcy** Yes No When**
Has it been Discharged** Yes No When**
Authorization Form


Gustavo (Gus) Banuelos
(323) 346-1500