Cash For Keys Feedback Memorandum

This form is an agreement to surrender the property voluntarily

Your Name:
From Email (Your email):
Day Telephone:
Night Telephone:
FAX:
 
Property Address 1:
Property Address 2:
Property City:
Property State:
Property Zipcode:
 
I have filed for bankruptcy:
I am interested in buying this property from the new owner:
 
I will accept the following amount as payment to move out (if you select other please write the amount and your reason in the comments section):
 
I will vacate the property by:
<December 2024>
SunMonTueWedThuFriSat
24252627282930
1234567
891011121314
15161718192021
22232425262728
2930311234
 
Name of all people residing in the property (includes all adults and children).
 
Comments:
 

Home Owners Association Information

In order to be considered for the cash for keys program you must provide information about the homeowners association for the occupied property. If there is no home owner's association please leave this section blank.
HOA Name:
HOA Address 1:
HOA Address 2:
HOA City:
HOA State:
HOA Zipcode:
 
Subdivision Name:
 
Number of Homes:
HOA Fees:
 
Contact Name:
Contact Phone:
Contact FAX:
Contact Email:
 
Website:
I understand there will be other documents that need to be completed. These additional documents may include a W-9 IRS form and relocation assistance forms.

In order to receive the funds, I understand all personal property, trash, and debris must be removed and the property must be in broom swept condition.

Lastly, the cash for keys relocation program is contingent upon upper manager's approval.

Thank you for responding. Please stand by.