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Seller Intake Form
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Seller intake form for Jim Duncan, Realtor with Nest Realty Group in Charlottesville, Virginia.
Questions? or 434-242-7140
Phone number
Type of Residence
Clear selection
Number of Bedrooms
Number of Bathrooms
Clear selection
If yes to garage, how many bays?
Year home was built?
Age of roof?
Age of HVAC(s)?
Association fees? (if applicable)
HOA Contact Information
Association Fee Covers?
What is your motivation for selling your home?
How long have you lived in your home?
When do you plan or think you would like to move?
Clear selection
What do you like about your current home or neighborhood?
List of Updates:
What repairs are needed in your opinion?
Goal List Price?
Mortgage Payoff:
Showing Instructions:
Do you have any pets? If so, what kind?
Utility Provider for Water:
Utility Provider for Sewer:
Utility Provider for Trash:
Utility Provider for Power:
Utility Provider for cable:
Energy Ratings(s)? (HERS, etc)
Do you have solar? Tell me about it if you do.
Private Well?  If so, what is the depth? Recovery rate?
Septic system?  If so, when was it last pumped?
Sump Pump?
Radon system in place?
Average Utilities Costs for: Water, Electric, Gas?
Do you have survey?
Home Warranty provider? If so, date of expiration?
HVAC annual service contract? If so, name of provider?
Termite/Pest annual service contract? If so, name of provider?
Additional Notes?
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