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Homeowner Pre-List Questionnaire
Homeowner intake form
Please answer as many questions as you can. Feel free to skip fields if you are unsure of an answer.
*
1.
My Name
(Required.)
*
2.
My address
(Required.)
3.
The date that I purchased my home
4.
My three favorite attributes of the
inside
of my home are:
1
2
3
5.
My three favorite attributes of the
outside
of my home are:
1
2
3
6.
Three things that I love about my neighborhood/ town/ city
1
2
3
7.
Interesting history about my home or neighborhood (i.e. George Washington had lunch here, we are near the site of a historic event, my home was designed by a renowned architect, etc.)
8.
The approximate age of my roof is:
9.
The approximate age of my Heating System is:
10.
Hy home has this many heating/ cooling zones (how many rooms have their own thermostat?)
11.
My heating system is fueled by
Natural Gas
Oil
Propane
Multiple Fuels
12.
My Average Annual Heating Fuel Cost is:
13.
My Average Annual Electricity Cost is:
14.
My home
has a private septic system
is connected to the city/ town sewer system
15.
My home's water comes from
City or Town Water
A Private Well
16.
Easements or rights of way on my property
I am aware of an easement or right of way
I am NOT aware of an easement or right of way
17.
Underground oil or storage tanks
I am NOT aware of any underground oil or storage tanks on my property
I AM aware of an underground oil or storage tank on my property
There was an underground oil or storage tank on my property, but it was removed
18.
My electrical panel has
Circuit Breakers (switches)
Fuses (round)
19.
Solar Panels
My home does NOT have any solar panels
My home is equipped with solar panels that I own
My home is equipped with solar panels that are leased
20.
My basement
Is always dry
Sometimes has a little seepage
Floods occasionally
Floods regularly
Is equipped with a sump pump and/ or perimeter drain
21.
I am aware of
Wetlands on my property
My property is in a flood zone/ flood insurance has been required
22.
Land Surveys,Property Lines, Encroachments (please check all that apply)
I have had my property surveyed or have been furnished a survey plan of my property
I am aware that a building or structure on my property may be encroaching on a neighbors property
I am aware that a building or structure on a neighbors property encroaches on mine
23.
I have completed the following major repairs or upgrades to my property (please include approximate date,information on permits, approximate or exact cost)
24.
Fixtures and Exclusions- Fixtures are defined as anything that is permanently affixed to your home (i.e. chandeliers, built-in furniture, window blinds, television mounts, appliances that are built-in, etc.) I wish to take the following fixtures with me when the home is sold;
25.
Personal Property- Personal property is defined as any item that is NOT permanently affixed to the home (i.e. a kitchen island that is not built in, furniture, etc.). I am willing to sell or leave at no cost the following personal property;
26.
Radon
What the heck is radon?
My home has a radon mitigation system
27.
Security
My home is equipped with a Security/ Alarm System
My home is equipped with a video/ surveillance System
My home contains audio listening devices (i.e Alexa, Ring Doorbell System etc.)
28.
If I were considering buying my home, I would want to know the following (positive or negative) things that may not be apparent at first glance (i.e. there are gorgeous sunsets in the evening, the neighbors host an annual block party, there is amazing bakery 3 blocks away, etc.)
