NOTE: If you enter a reference number, this site will attempt to validate that number against your exact registered name and often as a “Company / Entity” rather than an individual. For this reason, it’s often easier to simply leave out the reference number (it is optional). If you do want to use the reference number from the letter, use the name exactly as printed on the top of that letter.

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* Required Information

Owner Information

Is the property held in a company name, or Trust?

This property is owned by:

Individual(s)

Company/ Entity

*First Name:

*Last Name:

Primary Phone Number:

Optional Reference Number:

[?]

Click here if you are NOT the owner on title...

Click here if there is someone else on title with you...

Click here if title is held in a company name, or Trust...

Contact Information

Email:

*Primary Phone Number:

[?]

Fax Number:

*Mailing Address:

Mailing Address 2:

[?]

*City:

*State:

*Zip Code:

Property Information

*What State is the property located in?:

*What County is the property located in?:

*What is the property’s APN?:

[?]

What is the size of the property?:

	Acres	OR
	SQ. FT.

Is there an HOA in this area? If yes, what is your annual HOA dues?

Click here if you do NOT own this property FREE and CLEAR.

Are there any improvements on the property?:

House
Shed
Mobile Home
RV Hookup
Septic System
Well
Fence

Other:

Are there power lines to the property?:

Does the property have Road Access?:

How long have you owned your property?:

Yrs

How did you acquire this property?:

What is your estimated value for the property?:

Click here if you have listed this property with a realtor.

Is there anything else about the property that we should know about?

I verify that the form is complete and correct to the best of my knowledge.

Owner Information

Contact Information

Property Information

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