Name:

EMail:

Please take some time to answer a few questions for us,
so that we may better understand your requirements.

Describe Yourself >>>>> Homeowner Home Buyer Landlord Property Manager Tenant Real Estate Professional Educator Other

PROPERTY INFORMATION

Type of Dwelling >>>>>> Single Family Townhouse Duplex Multifamily Other

Age of property >>>>>>>

Window Types > Older wooden windows Replacement windows Older metal windows Unknown

RISK FACTORS

Do children or other Persons at Risk reside at property ? Yes No

Is there peeling, chipping or flaking paint on the inside ?> Yes No

Is there peeling, chipping or flaking paint on the outside ? Yes No

Is there bare soil around the dwelling ?>>>>>>>>>>>>>> Yes No

Have there been recent renovations at the property ?>>> Yes No

COMMENTS: