Good Samaritans, Inc.

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Investor Report: Cash for Future Equity
Here's a concept that real estate investors might want to check out: Cash for part of the future equity in their properties ... with no interest charges.

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Homeowners

HELP ME!

I NEED FORECLOSURE ASSISTANCE FAST!

PLEASE COMPLETE OUR QUICK RESPONSE FORECLOSURE FORM.

Items marked with an asterisk(*) are required, if unsure please provide an N/A (Not Applicable).

Referred By:

The Person or Company that Referred You


Referer's Full name:	Referer's Phone:

How did you hear about us?*

Homeowner Information


Full name:	Email:
*	*
What is your marital status?	Spouse name:
*
Best TWO contact numbers?
Phone #1:	Type
*	*
Phone #2:	Type
*	*
Best TIME to call you?
*

Property Information


Property Address :	City:
*	*
State:	Zip:
*	*
What County?	Is the property your:

What do you think your house is worth?	Source of value:

Who is living in the house?	Are you the owner of the record?

Your Situation


Do you wish to :	What solutions have you tried to work out with your lender?
*	*
Have you been served legal papers?	Do you know the sheriff sale date?
*
If yes, when is it?	Are you behind on payments?

Briefly describe how you got behind or are unable to make your mortgage payments.
*