Case Evaluation Company 1. Are you the owner of the house? * Yes No First Name * Phone Number * Last Name * Email Address * 2. Address of House: City * Address * State * - Select Province/State - Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code * 3. Is this a mobile home? * Yes No 4. How many bedrooms? * 1 2 3 4+ 5. How many bathrooms? * 1 2 3 4+ 6. What is the square footage of your house? * 7. What type of garage does your house have if any? 8. Does the house have a pool? * Yes No 9. Is this house listed with a realtor? * Yes No 10. How much equity is in the house? * 11. What is your monthly mortgage payment? * 12. How much is your interest rate? * 13. Are taxes and insurance escrowed? * Yes No 14. What is the value of the house? * 15. What are the required repairs on the house? * 16. Please provide a description of your issue. Data Privacy Compliance By using this form you agree with the storage and handling of your data by this website.