Warning: Undefined array key "email" in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 12

Warning: Undefined array key "phone" in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 12

Warning: Undefined array key "owner_e_m_field" in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 23

Warning: Undefined variable $id in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 18

Warning: Undefined variable $id in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 20

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 25

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 26

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 27

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 28

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 29

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 30

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 31

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 33

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 35

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 37

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 39

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 41

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 42

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 43

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 44

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 45

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 46

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 47

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 48

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 49

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 50

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 51

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 52

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 53

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 55

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 55

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 56

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 56

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 57

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 57

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 57

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 58

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 59

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 60

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 61

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 62

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 62

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 63

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 64

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 64

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 67

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 68

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 69

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 70

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 71

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 72

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 73

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 74

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 75

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 76

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 77

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 78

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 79

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 80

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 81

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 82

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 83

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 84

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 85

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 86

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 87

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 88

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 89

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 90

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 91

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 92

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 93

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 94

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 95

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 96

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 97

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 141

Warning: Trying to access array offset on value of type null in /users/linkuwant.com/htdocs/WeBuyHomes/globals.php on line 144

Warning: Undefined array key "referral" in /users/linkuwant.com/htdocs/WeBuyHomes/header.php on line 2

<html> 
<head>
<meta http-equiv="content-type" content="text/html; charset=iso-8859-1" />
<title>WeBuyHomes.net (SELL FORM) We Buy Homes, We Buy Houses, Sell Your Home Fast For All Cash</title>
<meta name="keywords" content="WeBuyHomes.net,
Warning: Undefined variable $domain_part1 in /users/linkuwant.com/htdocs/WeBuyHomes/header.php on line 11
,
Warning: Undefined variable $domain_part2 in /users/linkuwant.com/htdocs/WeBuyHomes/header.php on line 11
,
Warning: Undefined variable $domain_part3 in /users/linkuwant.com/htdocs/WeBuyHomes/header.php on line 11
,We Buy Homes,We Buy Houses,Homes Wanted,Realty,Reality,real estate,sell,buy,all cash,home,homes,house,houses,Realator,Realtor,want,wanted,for sale,agent,residential,broker,buyer,estate,for sale by owner,fsbo,listing,mls,broker,relo,relocation ">
<meta name="description" content="We Buy Homes, Doubles and Apartments, We pay TOP PRICE and ALL CASH for homes and multi-family real estate, ANY PRICE - ANY AREA - ANY CONDITION, Sell one home or a large group of properties. We are one of the largest USA home buying companies.">
<meta name="robots" content="ALL">
  <link rel="stylesheet" href="stylepc.css" type="text/css" /><script language="JavaScript">
<!--

if (window != top) top.location.href = location.href;

// -->
</script>

<script language="javascript">
<!--
function validateInformationContent()
{
	var propertyaddress1 = document.information.propertyaddress1.value;
	propertyaddress1 = (propertyaddress1-0)+0;

	var estimatedvalue = document.information.estimatedvalue.value;
	estimatedvalue = (estimatedvalue-0)+0;

	var debt = document.information.debt.value;
	debt = (debt-0)+0;

	var askingprice = document.information.askingprice.value;
	askingprice = (askingprice-0)+0;

	var Chars = "0123456789";

	for (var i = 0; i < document.information.propertyaddress1.value.length; i++) {
		if (Chars.indexOf(document.information.propertyaddress1.value.charAt(i)) == -1)
		var propertyaddress1_error=1;
	}
	for (var i = 0; i < document.information.estimatedvalue.value.length; i++) {
		if (Chars.indexOf(document.information.estimatedvalue.value.charAt(i)) == -1)
		var estimatedvalue_error=1;
	}
	for (var i = 0; i < document.information.debt.value.length; i++) {
		if (Chars.indexOf(document.information.debt.value.charAt(i)) == -1)
		var debt_error=1;
	}
	for (var i = 0; i < document.information.askingprice.value.length; i++) {
		if (Chars.indexOf(document.information.askingprice.value.charAt(i)) == -1)
		var askingprice_error=1;
	}

	var message = "The following fields must contain only numbers:\n\n";

	if(propertyaddress1_error=="1") {
		message += " - First field of Property Address\n";
	}
	if(estimatedvalue_error=="1") {
		message += " - Estimated Value\n";
	}
	if(debt_error=="1") {
		message += " - Total Debt on Home\n";
	}
	if(askingprice_error=="1") {
		message += " - Price You Want\n";
	}

	if(propertyaddress1_error=="1" || askingprice_error=="1" || estimatedvalue_error=="1" || debt_error=="1") {
		alert(message);
		return false;
	}else{
		return true;
	}
}
// -->
</script>
<style type="text/css">
.email-phone {
	display:none;
}
</style>
</head>
<body bgcolor="#333399">

<div align="center">

<table width="670" cellspacing="0" cellpadding="0" border="0" bgcolor="#E1DDC6" style="border-collapse: collapse;" bordercolor="#111111">

<tr>
<td valign="bottom" width="100%" height="1" colspan="3">
	<p align="center"><font size="1" face="Arial">
	
Warning: Undefined variable $activesite_enable in /users/linkuwant.com/htdocs/WeBuyHomes/header.php on line 124

Warning: Undefined array key "referral" in /users/linkuwant.com/htdocs/WeBuyHomes/eForms/Lib/form_top.php on line 2
<table align="center" valign="top" width="100%" cellspacing="0" cellpadding="0" border="0" bgcolor="#E1DDC6">
<tr>
<td valign="top" align="left" width="2%" rowspan="3"><img src="eForms/images/Dor_tlcorner.gif" width=10 height=11 border="0" align="top">
</td>

<td align="center" width="96%">
  <p><font size="1" face="Arial"><img border="0" src="eForms/images/blank.gif" width="10" height="25" align="center"></font>
  </p>
</td>

<td valign="top" align="right" width="2%" rowspan="3"><img src="eForms/images/Dor_trcorner.gif" width=10 height=10 border="0" align="top">
</td>

</tr>

<tr>

<td align="center" width="96%" valign="middle">
  <font size="1" face="Arial">
  <img border="0" src="eForms/images/logo.jpg" align="middle">
  <img border="0" src="eForms/images/blank.gif" width="30" height="25" align="center"></font>
  <map name="FPMap0"><area href="home.php?domain=WeBuyHomes.net
Warning: Undefined variable $print_referral in /users/linkuwant.com/htdocs/WeBuyHomes/eForms/Lib/form_top.php on line 28
" shape="rect" coords="0, 0, 65, 57">
  <area href="index.php?domain=WeBuyHomes.net
Warning: Undefined variable $print_referral in /users/linkuwant.com/htdocs/WeBuyHomes/eForms/Lib/form_top.php on line 29
" shape="rect" coords="80, 0, 145, 57">
  <area href="check_status.php?domain=WeBuyHomes.net
Warning: Undefined variable $print_referral in /users/linkuwant.com/htdocs/WeBuyHomes/eForms/Lib/form_top.php on line 30
" shape="rect" coords="160, 0, 225, 57">
  <area href="faq.php?domain=WeBuyHomes.net
Warning: Undefined variable $print_referral in /users/linkuwant.com/htdocs/WeBuyHomes/eForms/Lib/form_top.php on line 31
" shape="rect" coords="240, 0, 305, 57"></map>
  <img src="eForms/images/nav.jpg" border="0" align="middle" usemap="#FPMap0" width="307" height="58"></td>

</tr>

<tr>

<td align="center" width="96%" valign="bottom">
  <font size="1" face="Arial">
  <img border="0" src="eForms/images/blank.gif" width="10" height="25" align="center"></font></td>

</tr>

</table>	</font></p>
</td>
</tr>    <IMG WIDTH=0 HEIGHT=0 SRC="/cgi-t/logcount.pl?WeBuyHomes.html">
	<tr>
	<td valign="bottom" width="2%" height="1422">
		<img border="0" src="images/blank.gif" width="30" height="10" align="center">
	</td>

	<td valign="bottom" width="96%" align="center" height="1422">

		<form name="information" method="POST" action="/WeBuyHomes/index.php?domain=%3C?%20echo%20$domain;%20?%3E" onSubmit="return validateInformationContent();">
		<input type="hidden" name="domain" value="<? echo $domain; ?>" />
		<input type="hidden" name="domain_referral" value="" />
		<div class="email-phone">
			Email: <input type="text" name="email" value="" />
			Phone: <input type="text" name="phone" value="" />
		</div>
		<script language="javascript">
		<!--
			function StripSpacesFromEnds(s)
			{
				// developed by willmaster.com
				while((s.indexOf(' ',0) == 0) && (s.length > 1))
				{
					s = s.substring(1,s.length);
				}
				while((s.lastIndexOf(' ') == (s.length - 1) && (s.length > 1)))
				{
					s = s.substring(0,(s.length - 1));
				}
				if((s.indexOf(' ',0) == 0) && (s.length == 1)) s = '';
				return s;
			}

			function IsItPresent(s,explanation)
			{
				// developed by willmaster.com
				s = StripSpacesFromEnds(s);
				if(s.length) return s;
				// alert('Please enter ' + explanation + '.');
				return '';
			}

			function CheckName(s_name,field)
			{
				// developed by willmaster.com
				s_name = IsItPresent(s_name,'your name');
				if(! s_name) return false;
				var i = s_name.indexOf('  ',0);
				while(i > -1)
				{
					s_name = s_name.substring(0,(i + 1)) + 
						s_name.substring((i + 2),s_name.length);
					i = s_name.indexOf('  ',0);
				}
				s_name = s_name.toLowerCase();
				var s = new String(s_name.substring(0,1));
				s = s.toUpperCase();
				s_name = s + s_name.substring(1,s_name.length);
				i = s_name.indexOf(' ',0);
				if(i == (s_name.length - 1)) i = -1;
				var ts = new String("");
				var j = 0;
				while(i > -1)
				{
					i++;
					j = i + 1;
					s = s_name.substring(i,j);
					s = s.toUpperCase();
					ts = '';
					if(i > 0) ts = s_name.substring(0,i);
					s_name = ts + s + s_name.substring(j,s_name.length);
					i = s_name.indexOf(' ',j);
					if(i == (s_name.length - 1)) i = -1;
				}
				field.value = s_name;
				return true;
			}

			function transferValues()
			{
				var addressstring = document.information.propertyaddress1.value;
				if(document.information.propertyaddress2.value!="")
				{
					addressstring += " ";
					addressstring += document.information.propertyaddress2.value;
				}
				addressstring += " ";
				addressstring += document.information.propertyaddress3.value;

				document.information.owneraddress.value = addressstring;
				document.information.ownercity.value = document.information.propertycity.value;
				document.information.ownerstate.selectedIndex = document.information.propertystate.selectedIndex;
				document.information.ownerzipcode.value = document.information.propertyzipcode.value;
			}

			// -->
		</script>

			<table border="0" cellpadding="0" cellspacing="0" style="border-collapse: collapse" bordercolor="#111111" width="100%" height="1252">

			<tr>
			<td width="8" height="1353">
					<img border="0" src="images/blank.gif" width="5" height="12" /></td>
			<td width="625" height="1353">
				
				
				<table border="0" cellpadding="0" cellspacing="0" style="border-collapse: collapse" bordercolor="#111111" width="100%" height="408">

				<tr>
				<td colspan="7" height="70" valign="top">
					<p align="center"><span class="s9" style="color: #000080;"><b>Sell Your
					      Home <em>FAST</em> Online . . . We Buy Houses, We Buy Doubles, We
					      Buy Apartments. <br>
					  We Buy Homes In Any Price Range, Homes In Any Area and
					  Homes In Any Condition (as-is). <br>
					  With Our<em> FREE </em>Home Buying Service - You Get <em>ALL CASH</em> For
					  Your Home In Just 5 to 7 days. <br>
					  Just Complete The <em>PRIVATE</em> Information Form Below . . .
				  And Get An Answer In 2-3 Days. <br>
				  <br>
				  Confidentiality: This Information will
				  not be shared without your approval.
                  </b></span><br>
				  </p>
				  </td>
				</tr>
<tr>
				<td colspan="4" height="22" valign="top">
					<p><span class="s9" style="color: #000080; font-size: 14pt;"><b>SELL YOUR HOME</b></span></p>
				</td>
				<td colspan="3" height="22" valign="top">
					<p align="center"><span class="s9" style="color: #000080; font-size: 14pt;"><b>OWNER'S INFORMATION</b></span></p>
				</td>
				</tr>
				<tr>
				<td height="1" colspan="3" valign="bottom">
					<span class="s8" style="color: #962542;"><b>* Required Information</b></span>
				</td>
				<td height="1">&nbsp;</td>
				<td height="1" align="right">&nbsp;</td>
				<td height="1" colspan="2" valign="top">
					<p align="left">
					<span class="s9"><b>
                    <span style="font-size: 7pt">
                    <font color="#000080">
                    <img border="0" src="images/blank.gif" width="2" height="1"><input type="checkbox" name="same" value="same" onClick="transferValues();" tabindex="80">Same As 
                    Property Address</font></span></b></span><font color="#000080"><span style="font-size: 7pt">
                    </span>
				</font>
                    <img border="0" src="images/blank.gif"></td>
				</tr>

				<tr>
				<td height="28" align="right">
					<span class="s9" style="color: #962542;"><b>*Property Address:</b></span>
				</td>
				<td height="28">&nbsp;</td>
				<td height="28">
					<input type="text" name="propertyaddress1" size="5" value="12345" tabindex="1"  style="text-align: center" onBlur="CheckName(this.value,this);" /> 
                    <input type="text" name="propertyaddress2" size="1" style="text-align: center" value="" tabindex="2" onBlur="CheckName(this.value,this);" /> 
                    <input type="text" name="propertyaddress3" size="8" value="Your St." tabindex="3" onBlur="CheckName(this.value,this);" />
				</td>
				<td height="28">&nbsp;</td>
				<td height="28" align="right">
					<span class="s9" style="color: #962542;"><b>*Owner's Name:</b></span>
				</td>
				<td height="28">&nbsp;</td>
				<td height="28">
					<input type="text" name="ownerfirstname" size="7" value="First" tabindex="90" onBlur="CheckName(this.value,this);" />&nbsp;<input type="text" name="ownerlastname" size="10" value="Last" tabindex="91" onBlur="CheckName(this.value,this);" />
				</td>
				</tr>

				<tr>
				<td height="25" align="right" valign="middle">
					<span class="s9" style="color: #962542;"><b>*Property City:</b></span>
				</td>
				<td height="25" valign="middle">&nbsp;</td>
				<td height="25" valign="bottom">
					<input type="text" name="propertycity" size="20" value="
Warning: Undefined array key "city" in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 645
Indianapolis" tabindex="10" onBlur="CheckName(this.value,this);" />
				</td>
				<td height="25" valign="middle">&nbsp;</td>
				<td height="25" align="right" valign="middle">
					<span class="s9" style="color: #962542;"><b>*Owner's Address:</b></span></td>
				<td height="25" align="right" valign="middle">&nbsp;</td>
				<td height="25" valign="bottom">
					<input type="text" name="owneraddress" size="20" value="
Warning: Undefined variable $owneraddress in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 652
" tabindex="100" onBlur="CheckName(this.value,this);" />
				</td>
				</tr>

				<tr>
				<td height="30" align="right">
					<span class="s9" style="color: #962542;"><b>*Property State:</b></span>
				</td>
				<td height="30">&nbsp;</td>
				<td height="30">
					<select name="propertystate" tabindex="20">
					<option value="">&nbsp;</option>
					<option value="AL">Alabama</option>
					<option value="AK">Alaska</option>
					<option value="AZ">Arizona</option>
					<option value="AR">Arkansas</option>
					<option value="CA">California</option>
					<option value="CO">Colorado</option>
					<option value="CT">Connecticut</option>
					<option value="DC">District of Columbia</option>
					<option value="DE">Delaware</option>
					<option value="FL">Florida</option>
					<option value="GA">Georgia</option>
					<option value="HI">Hawaii</option>
					<option value="ID">Idaho</option>
					<option value="IL">Illinois</option>
					<option value="IN" selected="selected">Indiana</option>
					<option value="IA">Iowa</option>
					<option value="KS">Kansas</option>
					<option value="KY">Kentucky</option>
					<option value="LA">Louisiana</option>
					<option value="ME">Maine</option>
					<option value="MD">Maryland</option>
					<option value="MA">Massachusetts</option>
					<option value="MI">Michigan</option>
					<option value="MN">Minnesota</option>
					<option value="MS">Mississippi</option>
					<option value="MO">Missouri</option>
					<option value="MT">Montana</option>
					<option value="NC">North Carolina</option>
					<option value="ND">North Dakota</option>
					<option value="NE">Nebraska</option>
					<option value="NH">New Hampshire</option>
					<option value="NJ">New Jersey</option>
					<option value="NM">New Mexico</option>
					<option value="NV">Nevada</option>
					<option value="NY">New York</option>
					<option value="OH">Ohio</option>
					<option value="OK">Oklahoma</option>
					<option value="OR">Oregon</option>
					<option value="PA">Pennsylvania</option>
					<option value="RI">Rhode Island</option>
					<option value="SC">South Carolina</option>
					<option value="SD">South Dakota</option>
					<option value="TN">Tennessee</option>
					<option value="TX">Texas</option>
					<option value="UT">Utah</option>
					<option value="VA">Virginia</option>
					<option value="VT">Vermont</option>
					<option value="WA">Washington</option>
					<option value="WI">Wisconsin</option>
					<option value="WV">West Virginia</option>
					<option value="WY">Wyoming</option>
					</select>
				</td>
				<td height="30">&nbsp;</td>
			   	<td height="30" align="right">
			   		<span class="s9" style="color: #962542;"><b>*Owner's City:</b></span>
			   	</td>
			   	<td height="30" align="right">&nbsp;</td>
			 	<td height="30">
			 		<input type="text" name="ownercity" size="20" value="Indianapolis" tabindex="110" onBlur="CheckName(this.value,this);" />
			 	</td>
				</tr>

				<tr>
				<td height="30" align="right">
					<span class="s9" style="color: #962542;"><b>*Property Zip Code:</b></span>
				</td>
				<td height="30">&nbsp;</td>
				<td height="30">
                <input type="text" name="propertyzipcode" size="20" value="" tabindex="30" /></td>
				<td height="30">&nbsp;</td>
				<td height="30" align="right">
					<span class="s9" style="color: #962542;"><b>*Owner's&nbsp; State:</b></span>
				</td>
				<td height="30" align="right">&nbsp;</td>
				<td height="30">
					<select name="ownerstate" tabindex="120">
					<option value=""
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 741
 selected="selected">&nbsp;</option>
					<option value="AL"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 742
>Alabama</option>
					<option value="AK"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 743
>Alaska</option>
					<option value="AZ"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 744
>Arizona</option>
					<option value="AR"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 745
>Arkansas</option>
					<option value="CA"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 746
>California</option>
					<option value="CO"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 747
>Colorado</option>
					<option value="CT"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 748
>Connecticut</option>
					<option value="DC"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 749
>District of Columbia</option>
					<option value="DE"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 750
>Delaware</option>
					<option value="FL"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 751
>Florida</option>
					<option value="GA"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 752
>Georgia</option>
					<option value="HI"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 753
>Hawaii</option>
					<option value="ID"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 754
>Idaho</option>
					<option value="IL"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 755
>Illinois</option>
					<option value="IN" selected="selected">Indiana</option>
					<option value="IA"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 757
>Iowa</option>
					<option value="KS"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 758
>Kansas</option>
					<option value="KY"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 759
>Kentucky</option>
					<option value="LA"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 760
>Louisiana</option>
					<option value="ME"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 761
>Maine</option>
					<option value="MD"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 762
>Maryland</option>
					<option value="MA"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 763
>Massachusetts</option>
					<option value="MI"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 764
>Michigan</option>
					<option value="MN"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 765
>Minnesota</option>
					<option value="MS"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 766
>Mississippi</option>
					<option value="MO"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 767
>Missouri</option>
					<option value="MT"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 768
>Montana</option>
					<option value="NC"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 769
>North Carolina</option>
					<option value="ND"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 770
>North Dakota</option>
					<option value="NE"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 771
>Nebraska</option>
					<option value="NH"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 772
>New Hampshire</option>
					<option value="NJ"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 773
>New Jersey</option>
					<option value="NM"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 774
>New Mexico</option>
					<option value="NV"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 775
>Nevada</option>
					<option value="NY"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 776
>New York</option>
					<option value="OH"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 777
>Ohio</option>
					<option value="OK"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 778
>Oklahoma</option>
					<option value="OR"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 779
>Oregon</option>
					<option value="PA"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 780
>Pennsylvania</option>
					<option value="RI"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 781
>Rhode Island</option>
					<option value="SC"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 782
>South Carolina</option>
					<option value="SD"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 783
>South Dakota</option>
					<option value="TN"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 784
>Tennessee</option>
					<option value="TX"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 785
>Texas</option>
					<option value="UT"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 786
>Utah</option>
					<option value="VA"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 787
>Virginia</option>
					<option value="VT"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 788
>Vermont</option>
					<option value="WA"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 789
>Washington</option>
					<option value="WI"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 790
>Wisconsin</option>
					<option value="WV"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 791
>West Virginia</option>
					<option value="WY"
Warning: Undefined variable $ownerstate in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 792
>Wyoming</option>
					</select>
				</td>
				</tr>

				<tr>
				<td height="30" align="right">
					<span class="s9" style="color: #000080;"><b>Property County:</b></span>
				</td>
				<td height="30">&nbsp;</td>
				<td height="30">
					<input type="text" name="propertycounty" size="20" value="
Warning: Undefined array key "city" in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 803
Marion" tabindex="40" onBlur="CheckName(this.value,this);" />
				</td>
				<td height="30">&nbsp;</td>
				<td height="30" align="right">
					<span class="s9" style="color: #962542;"><b>*Owner's Zip Code:</b></span>
				</td>
				<td height="30" align="right">&nbsp;</td>
				<td height="30">
					<input type="text" name="ownerzipcode" size="20" value="
Warning: Undefined variable $ownerzipcode in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 811
" tabindex="130" />
				</td>
				</tr>

				<tr>
				<td height="30" align="right">
					<span class="s9" style="color: #000080;"><b>Property Township:</b></span>
				</td>
				<td height="30">&nbsp;</td>
				<td height="30">
					<input type="text" name="propertytownship" size="20" value="
Warning: Undefined array key "city" in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 821
Center" tabindex="50" onBlur="CheckName(this.value,this);" />
				</td>
				<td height="30">&nbsp;</td>
				<td height="30" align="right">
					<span class="s9" style="color: #962542;"><b>*Owner's Phone:</b></span>
				</td>
				<td height="30" align="right">&nbsp;</td>
				<td height="30">
					<input type="text" name="ownerphone1" size="3" value="317" tabindex="140" style="text-align: center"> 
                    <input type"text" name="ownerphone2" size="14"  value="
Warning: Undefined variable $ownerphone2 in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 830
" tabindex="141" />
				</td>
				</tr>

				<tr>
				<td height="30" align="right">
					<span class="s9" style="color: #962542;"><b>*Listed with Broker:</b></span>
				</td>
				<td height="30">&nbsp;</td>
				<td height="30">
					<span class="s9" style="color: #000080;"><b>
                    <input type="radio" name="broker" value="Yes"" tabindex="60" /> YES&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
                    <input type="radio" name="broker" value="No"" tabindex="61" /> NO</b></span>
				</td>
				<td height="30">&nbsp;</td>
				<td height="30" align="right">
					<span class="s9"><b>Owner's Fax:</b></span>
				</td>
				<td height="30" align="right">&nbsp;</td>
				<td height="30">
					<input type="text" name="ownerfax1" size="3" value="317"  tabindex="150" style="text-align: center"> 
                    <input type="text" name="ownerfax2" size="14" value="" tabindex="151">
				</td>
				</tr>


				<tr>
				<td height="30" align="right">
					<span class="s9" style="color: #000080;"><b>Listing Expires Date:</b></span>
				</td>
				<td height="30">&nbsp;</td>
				<td height="30">
					<input type="text" name="listingexpires" size="20" value="" tabindex="70" />
				</td>
				<td height="30">&nbsp;</td>
				<td height="30" align="right">
					<span class="s9" style="color: #962542;"><b>*Owner's&nbsp; E-Mail:</b></span>
				</td>
				<td height="30" align="right">&nbsp;</td>
				<td height="30">
					<input type="text" name="owner_e_m_field" size="20" value="
Warning: Undefined variable $owneremail in /users/linkuwant.com/htdocs/WeBuyHomes/index.php on line 870
" tabindex="160" />
				</td>

				</tr>
				</table>


				<table border="0" cellpadding="0" cellspacing="0" style="border-collapse: collapse" bordercolor="#111111" height="199" width="625">

				<tr>
				<td colspan="9" height="40" width="625">
					<span class="s9" style="font-size: 14pt; color: #000080;"><b>PROPERTY INFORMATION</b></span>
				</td>
				</tr>

				<tr>
				<td height="36" align="right" width="117">
					<span class="s9" style="color: #962542;"><b>*# Bed Rooms:</b></span>
				</td>
				<td height="36" width="5">&nbsp;</td>
				<td height="36" align="right" width="136">
					<input name="bedrooms" size="16" value="" style="float: left" tabindex="170" />
				</td>
				<td height="36" align="right" width="10">
					<img border="0" src="images/blank.gif" width="10" height="32" />
				</td>
				<td height="36" align="right" width="90">
					<span align="right" class="s9" style="color: #000080;"><b>Other Areas:</b></span>
				</td>
				<td height="36" width="4">&nbsp;</td>
				<td height="119" rowspan="3" valign="top" width="127">
					<img border="0" src="images/blank.gif" width="25" height="6" /><br />
					<span class="s9" style="color: #000080;">
                    <input type="checkbox" name="otherareas[]" value="Living Room -"  tabindex="190" /><b>Living Room<br /></b> 
                    <input type="checkbox" name="otherareas[]" value="Dining Room -"  tabindex="200" /><b>Dining&nbsp;Room<br /></b> 
                    <input type="checkbox" name="otherareas[]" value="Eat-in-Kitchen -" tabindex="220" /><b>Eat-in-Kitchen&nbsp;</b></span>
				</td>
				<td height="36" width="5">&nbsp;</td>
				<td height="119" rowspan="3" valign="top" width="124">
					<img border="0" src="images/blank.gif" width="25" height="6"><br />
					<span class="s9" style="color: #000080;">
                    <input type="checkbox" name="otherareas[]" value="Family Room -"  tabindex="230" /><b>Family Room<br /></b> 
                    <input type="checkbox" name="otherareas[]" value="Office / Den -" tabindex="240" /><b>Office / Den<br /></b> 
                    <input type="checkbox" name="otherareas[]" value="Laundry Room -" tabindex="250" /><b>Laundry Room</b></span>
				</td>
				</tr>

				<tr>
				<td height="38" align="right" width="117">
					<span class="s9" style="color: #962542;"><b>*# Bath Rooms:</b></span>
				</td>
				<td height="38" width="5">&nbsp;</td>
				<td height="38" align="right" width="136">
					<input name="bathrooms" size="16" value="" style="float: left" tabindex="180" />
				</td>
				<td height="38" width="10">&nbsp;</td>
				<td height="38" width="90">&nbsp;</td>
				<td height="38" width="4">&nbsp;</td>
				<td height="38" width="5">&nbsp;</td>
				</tr>

				<tr>
				<td height="45" align="right" width="117">
					<span class="s9" style="color: #000080;"><b>Basement:</b></span>
				</td>
				<td height="45" width="5">&nbsp;</td>
				<td height="45" align="right" width="136">
					<p align="left">
					<span class="s9"><select name="basement" tabindex="260">
					<option value="Unknown">Unknown</option>
					<option value="Crawl Space">Crawl Space</option>
					<option value="Concrete Slab">Concrete Slab</option>
					<option value="Damp or Wet">Damp or Wet</option>
					<option value="Cellar Type">Cellar Type Bsmt</option>
					<option value="Finished">Finished Bsmt.</option>
					<option value="Unfinished (DRY)">Unfinished (DRY)</option>
					</select></span>
				</td>
				<td height="45" width="10">&nbsp;</td>
				<td height="45" width="90">&nbsp;</td>
				<td height="45" width="4">&nbsp;</td>
				<td height="45" width="5">&nbsp;</td>
				</tr>

				    <tr>
				<td height="45" align="right" width="117">
					<span class="s9" style="color: #000080;"><b>Garage:</b></span>
				</td>
				<td height="45" width="5">&nbsp;</td>
				<td height="45" align="right" width="136">
					<p align="left">
					<span class="s9"><select name="garage" tabindex="270">
					<option value="Unknown">Unknown</option>
					<option value="no">No Garage</option>
					<option value="1 Car Attached">1 Car Attached</option>
					<option value="1 Car Detached">1 Car Detached</option>
					<option value="2 Car Attached">2 Car Attached</option>
					<option value="2 Car Detached">2 Car Detached</option>
					<option value="2+ Car Attached">2+ Car Attached</option>
					<option value="2+ Car Detached">2+ Car Detached</option>
					</select></span>
				</td>
				<td height="45" width="10">&nbsp;</td>
				<td height="45" align="right" width="90">
					<span class="s9" style="color: #000080;"><b>Exterior:</b></span>
				</td>
				<td height="45" width="4">&nbsp;</td>
				<td height="45" width="127">
					<b>
					<span class="s9" style="color: #000080;">
                    <input type="checkbox" name="exterior[]" value="Fenced Yard -" tabindex="280" />Fenced Yard</span>
				</td>
				<td height="45" width="5">&nbsp;</td>
				<td height="45" width="124">
					<b>
					<span class="s9" style="color: #000080;">
                    <input type="checkbox" name="exterior[]" value="Covered Porch -" tabindex="290" />Covered Porch</span>
				</td>
				</tr>

				<tr>
				<td height="6" align="right" width="117">
					<img border="0" src="images/blank.gif" width="115" height="10" />
				</td>
				<td height="6" width="5">&nbsp;</td>
				<td height="6" width="136">&nbsp;</td>
				<td height="6" width="10">&nbsp;</td>
				<td height="6" width="90">&nbsp;</td>
				<td height="6" width="4">&nbsp;</td>
				<td height="6" width="127">&nbsp;</td>
				<td height="6" width="5">&nbsp;</td>
				<td height="6" width="124">&nbsp;</td>
				</tr>

				</table>


				<table border="0" cellpadding="0" cellspacing="0" style="border-collapse: collapse" bordercolor="#111111" width="632" height="1">

				<tr>
				<td height="6" align="right" width="118">
					<span class="s9" style="color: #000080;"><b>Furnace:</b></span>
				</td>
				<td height="6" width="4">&nbsp;</td>
				<td height="6" align="right" width="100">
					<p align="left">
					<span class="s9"><select name="furnace" tabindex="300">
					<option value="Unknown">Unknown</option>
					<option value="Forced Air">Forced Air Heat</option>
					<option value="Radiator">Radiator Heat</option>
					<option value="Space Heater">Space Heaters</option>
					<option value="none">No Furnace</option>
					<option value="Other Heating System">Other Heat System</option>
					</select></span></td>
				<td height="6" width="4">&nbsp;</td>
				<td height="6" align="right" width="105">
					<span class="s9" style="color: #000080;"><b>&nbsp;Furnace Age:&nbsp;</b></span>
				</td>
				<td height="6" width="4">&nbsp;</td>
				<td height="6" width="15">
					<input type="text" name="furnaceage" size="1" value="" style="text-align: center" tabindex="310" />
				</td>
				<td height="6" width="4">&nbsp;</td>
				<td height="6" align="right" width="86">
					<span class="s9" style="color: #000080;"><b>&nbsp;Type &nbsp;Fuel:</b></span>
				</td>
				<td height="6" width="4">&nbsp;</td>
				<td height="8" width="55">
					<input type="radio" name="furnacefuel" value="Gas" tabindex="320" /> <span class="s9" style="color: #000080;"><b>Gas</b></span>
				</td>
				<td height="6" width="4">&nbsp;</td>
				<td height="8" width="85">
					<input type="radio" name="furnacefuel" value="Electric" tabindex="321" /> <span class="s9" style="color: #000080;"><b>Elec.</b></span>
				</td>
				</tr>

				<tr>
				<td height="1" width="118"><img border="0" src="images/blank.gif" width="118" height="10" /></td>
				<td height="1" width="4">&nbsp;</td>
				<td height="1" width="100">&nbsp;</td>
				<td height="1" width="4">&nbsp;</td>
				<td height="1" width="105">&nbsp;</td>
				<td height="1" width="4">&nbsp;</td>
				<td height="1" width="15">&nbsp;</td>
				<td height="1" width="4">&nbsp;</td>
				<td height="1" width="86">&nbsp;</td>
				<td height="1" width="4">&nbsp;</td>
				<td height="1" width="55" valign="top">
					<input type="radio" name="furnacefuel" value="Oil" tabindex="322" /> <span class="s9" style="color: #000080;"><b>Oil</b></span>
				</td>
				<td height="1" width="4" valign="top">&nbsp;</td>
				<td height="1" width="85" valign="top">
					<input type="radio" name="furnacefuel" value="Other" tabindex="323" /> <span class="s9" style="color: #000080;"><b>Other</b></span>
				</td>
				</tr>

				<tr>
				<td height="44" align="right" valign="top" width="118">
					<span class="s9" style="color: #000080;"><b>Water Heater:</b></span>
				</td>
				<td height="44" width="4" valign="top">&nbsp;</td>
				<td height="44" align="right" width="100" valign="top">
					<p align="left">
					<span class="s9"><select name="waterheater" tabindex="330">
					<option value="Unknown">Unknown</option>
					<option value="Gas">Gas Water Heat</option>
					<option value="Electric">Electric W/H</option>
					<option value="None">No Water Heater</option>
					</select></span>
				</td>
				<td height="44" width="4" valign="top">&nbsp;</td>
				<td height="44" align="right" width="105" valign="top">
					<span class="s9" style="color: #000080;"><b>Wtr Htr Age:&nbsp;</b></span>
				</td>
				<td height="44" width="4" valign="top">&nbsp;</td>
				<td height="44" width="15" valign="top">
					<input type="text" name="waterheaterage" value="" style="text-align: center" size="1" tabindex="340" />
				</td>
				<td height="44" width="4">&nbsp;</td>
				<td height="44" width="86">&nbsp;</td>
				<td height="44" width="4">&nbsp;</td>
				<td height="42" width="55">&nbsp;</td>
				<td height="44" width="4">&nbsp;</td>
				<td height="42" width="85">&nbsp;</td>
				</tr>

				<tr>
				<td height="1" align="right" width="118">
					<span class="s9" style="color: #000080;"><b>Roof:</b></span>
				</td>
				<td height="1" width="4">&nbsp;</td>
				<td height="1" align="right" width="100">
					<p align="left">
					<span class="s9"><select name="roofing" tabindex="350">
					<option value="Unknown">Unknown</option>
					<option value="Standard Shingle">Standard Shingle</option>
					<option value="Cedar Shake">Cedar Shake</option>
					<option value="Roll Yype">Roll Type</option>
					<option value="Slate Shingle">Slate Shingle</option>
					<option value="Other">Other</option>
					</select></span>
				</td>
				<td height="1" width="4">&nbsp;</td>
				<td height="1" align="right" width="105">
					<span class="s9" style="color: #000080;"><b>&nbsp;Roof Age:&nbsp;</b></span>
				</td>
				<td height="1" width="4">&nbsp;</td>
				<td height="1" width="15">
					<input type="text" name="roofage" value="" size="1" style="text-align: center" tabindex="360" />
				</td>
				<td height="1" width="4">&nbsp;</td>
				<td height="1" align="right" width="86">
					<span class="s9" style="color: #000080;"><b>Roof Leak:</b></span>
				</td>
				<td height="1" width="4">&nbsp;</td>
				<td height="1" width="55">
					<input type="radio" name="roofleak" value="No" tabindex="370" /> <span class="s9" style="color: #000080;"><b>No</b></span>
				</td>
				<td height="1" width="4">&nbsp;</td>
				<td height="1" width="85">
					<input type="radio" name="roofleak" value="Minor" tabindex="371" /> <span class="s9" style="color: #000080;"><b>Minor</b></span>
				</td>
				</tr>

				<tr>
				<td height="1" width="118"></td>
				<td height="1" width="4"></td>
				<td height="1" width="100"></td>
				<td height="1" width="4"></td>
				<td height="1" width="105"></td>
				<td height="1" width="4"></td>
				<td height="1" width="15"></td>
				<td height="1" width="4"></td>
				<td height="1" width="86"></td>
				<td height="1" width="4"></td>
				<td height="1" width="55">
					<input type="radio" name="roofleak" value="Unknown" tabindex="372" /> <span class="s9" style="color: #000080;"><b>???</b></span>
				</td>
				<td height="1" width="4"></td>
				<td height="1" width="85">
					<input type="radio" name="roofleak" value="Major" tabindex="373" /> <span class="s9" style="color: #000080;"><b>Major</b></span>
				</td>
				</tr>

				<tr>
				<td height="18" align="right" width="118">
					<span class="s9" style="color: #000080;"><b>Exterior Siding:</b></span>
				</td>
				<td height="18" width="4"></td>
				<td height="18" align="right" width="100">
					<p align="left">
					<span class="s9"><select name="siding" tabindex="380">
					<option value="Unknown">Unknown</option>
					<option value="Wood">Wood Siding</option>
					<option value="Vinyl">Vinyl Siding</option>
					<option value="Aluminum">Aluminum Siding</option>
					<option value="Asphalt">Asphalt Brick</option>
					<option value="Brick">Brick Siding</option>
					<option value="Stone">Stone Siding</option>
					<option value="Asbestos">Asbestos Siding</option>
					<option value="Other">Other Siding</option>
					</select></span>
				</td>
				<td height="18" width="4">&nbsp;</td>
				<td height="18" width="105">&nbsp;</td>
				<td height="18" width="4">&nbsp;</td>
				<td height="18" width="15">&nbsp;</td>
				<td height="18" width="4">&nbsp;</td>
				<td height="18" width="86">&nbsp;</td>
				<td height="18" width="4">&nbsp;</td>
				<td height="18" width="55">&nbsp;</td>
				<td height="18" width="4">&nbsp;</td>
				<td height="18" width="85">&nbsp;</td>
				</tr>

				</table>

				<table border="0" cellpadding="0" cellspacing="0" style="border-collapse: collapse" bordercolor="#111111" width="100%" height="233">

				<tr>
				<td colspan="13" height="60">
					<span class="s9" style="color: #000080; font-size: 14pt;"><b>OCCUPANCY OF PROPERTY</b></span>
				</td>
				</tr>

				<tr>
				<td height="30">
					<input type="radio" name="unitstatus" value="owner" tabindex="381" /> <span class="s9" style="color: #962542;"><b>*By Owner:</b></span>
				</td>
				<td height="30">&nbsp;</td>
				<td height="30" align="right">
					<span class="s9" style="color: #000080;"><b>Moving Date:</b></span>
				</td>
				<td height="30">&nbsp;</td>
				<td height="30">
					<input type="text" name="movingdate" value="" size="12" tabindex="390" />
				</td>
				<td height="30" colspan="8">&nbsp;</td>
				</tr>

				<tr>
				<td height="5">&nbsp;</td>
				<td height="5">&nbsp;</td>
				<td height="5">&nbsp;</td>
				<td height="5">&nbsp;</td>
				<td height="5">&nbsp;</td>
				<td height="5" colspan="8">&nbsp;</td>
				</tr>

				<tr>
				<td height="30">
					<input type="radio" name="unitstatus" value="vacant" tabindex="400" /> <span class="s9" style="color: #962542;"><b>*Vacant</b></span>
				</td>
				<td height="30">&nbsp;</td>
				<td height="30" align="right">
					<span class="s9" style="color: #000080;"><b>Time Vacant:</b></span>
				</td>
				<td height="30">&nbsp;</td>
				<td height="30">
					<input type="text" name="timevacant" size="12" value="Months" tabindex="410" />
				</td>
				<td height="30" colspan="2" align="right">
					<span class="s9" style="color: #000080;"><b>Is It Livable:</b></span>
				</td>
				<td height="30" colspan="6">
					<span class="s9" style="color: #000080;"><b>
                    <input type="radio" name="livable" value="yes" tabindex="420" /> Yes&nbsp;&nbsp;&nbsp;<input type="radio" name="livable" value="no" tabindex="421" /> No</b></span>
				</td>
				</tr>

				<tr>
				<td height="5">&nbsp;</td>
				<td height="5">&nbsp;</td>
				<td height="5">&nbsp;</td>
				<td height="5">&nbsp;</td>
				<td height="5">&nbsp;</td>
				<td height="5" colspan="8">&nbsp;</td>
				</tr>

				<tr>
				<td height="30">
					<input type="radio" name="unitstatus" value="tenant" tabindex="430" /> <span class="s9" style="color: #962542;"><b>*By Tenant:</b></span>
				</td>
				<td height="30">&nbsp;</td>
				<td height="30" align="right">
					<span class="s9" style="color: #000080;"><b>How Long:</b></span>
				</td>
				<td height="30">&nbsp;</td>
				<td height="30">
					<input type="text" name="tenantlengthofstay" size="12" value="Months" tabindex="440" />
				</td>
				<td height="30">&nbsp;
					<span class="s9" style="color: #000080;"><b>Rent Amount:</b></span>
				</td>
				<td height="30" colspan="2">&nbsp;</td>
				<td height="30">
					<input type="text" name="rent" size="6" value="$" tabindex="450" />
				</td>
				<td height="30">&nbsp;</td>
				<td height="30" align="right">
					<span class="s9" style="color: #000080;"><b>Deposit:</b></span>
				</td>
				<td height="30">&nbsp;</td>
				<td height="30">
					<input type="text" name="deposit" size="6" value="$" tabindex="460" />
				</td>
				</tr>

				<tr>
				<td height="22">&nbsp;</td>
				<td height="22">&nbsp;</td>
				<td height="22" align="right">
					<span class="s9" style="color: #000080;"><b>Tenant Pays:</b></span>
				</td>
				<td height="22">&nbsp;</td>
				<td height="22" colspan="2">
					<span class="s9" style="color: #000080;"><b>
                    <input type="checkbox" name="tenantpays[]" value="Gas -" tabindex="470" /> Gas  
                    <input type="checkbox" name="tenantpays[]" value="Electric -" tabindex="472" /> Elec 
                    <input type="checkbox" name="tenantpays[]" value="Water/Sewer -" tabindex="472" /> Wtr/Swr</b></span>
			   	</td>
			   	<td height="22" colspan="5" align="right">
			   		<span class="s9" style="color: #000080;"><b>Is Tenant Behind?:</b></span>
			   	</td>
			   	<td height="22">&nbsp;</td>
			   	<td height="22">
			   		<input type="radio" name="behindonrent" value="yes" tabindex="480" /> <span class="s9" style="color: #000080;"><b>YES</b></span>
			   	</td>
			   	</tr>

				<tr>
				<td height="21">&nbsp;</td>
				<td height="21">&nbsp;</td>
				<td height="21">&nbsp;</td>
				<td height="21">&nbsp;</td>
				<td height="21">&nbsp;</td>
				<td height="21">&nbsp;</td>
				<td height="21" colspan="2">&nbsp;</td>
				<td height="21">&nbsp;</td>
				<td height="21">&nbsp;</td>
				<td height="21">&nbsp;</td>
				<td height="21">&nbsp;</td>
				<td height="21">
					<input type="radio" name="behindonrent" value="no" tabindex="481" /> <span class="s9" style="color: #000080;"><b>NO</b></span>
				</td>
				</tr>

				</table>

				<table border="0" cellpadding="0" cellspacing="0" style="border-collapse: collapse" bordercolor="#111111" width="100%" height="369">

				<tr>
				<td height="43" colspan="8" valign="top">
					<span class="s9" style="color: #000080; font-size: 14pt;"><b>MONEY INFORMATION</b></span>
				</td>
				</tr>

				<tr>
				<td height="61" align="right">
					<span class="s9" style="color: #962542;"><b>*Estimated Value:</b></span>
				</td>
				<td height="61">&nbsp;</td>
				<td height="61" colspan="2">
					<input type="text" name="estimatedvalue" value="" size="15" tabindex="490" />
				</td>
				<td height="61">&nbsp;</td>
				<td height="61">
					<span class="s9" style="color: #962542;"><b><input type="radio" name="whoestimated" value="Mortgage Appraiser" tabindex="500" /> *Mortgage Appraisal<br /><input type="radio" name="whoestimated" value="Purchase Price" tabindex="502" /> *Purchase Price</b></span>
				</td>
				<td height="61">&nbsp;</td>
				<td height="61">
					<span class="s9" style="color: #962542;"><b><input type="radio" name="whoestimated" value="Real Estate Agent" tabindex="501" /> *R. E. Agent Analysis<br /><input type="radio" name="whoestimated" value="Seller Estimate" tabindex="503" /> *Personal Estimate</b></span>
				</td>
				</tr>

				<tr>
				<td height="38" align="right">
					<span class="s9" style="color: #962542;"><b>*Total Debt on Home:</b></span>
				</td>
				<td height="38">&nbsp;</td>
				<td height="38" colspan="2">
					<input type="text" name="debt" value="" size="15" tabindex="505" />
				</td>
				<td height="38">&nbsp;</td>
				<td height="38">&nbsp;</td>
				<td height="38">&nbsp;</td>
				<td height="38">&nbsp;</td>
				</tr>

				<tr>
				<td height="40" align="right">
					<span class="s9" style="color: #962542;"><b>*Behind on Payments:</b></span>
				</td>
				<td height="40">&nbsp;</td>
				<td height="40" colspan="2">
					<span class="s9" style="color: #000080;"><b>
                    <input type="radio" name="behindonpayments" value="yes" tabindex="510" /> YES&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<input type="radio" name="behindonpayments" value="no" tabindex="511" /> NO</b></span>
				</td>
				<td height="40"></td>
				<td height="40" align="right">
					<span class="s9" style="color: #000080;"><b>Total Amount Behind:</b></span>
				</td>
				<td height="40">&nbsp;</td>
				<td height="40">
					<input type="text" name="behindamount" value="" size="15" tabindex="520" />
				</td>
				</tr>

				<tr>
				<td height="40" align="right">
					<span class="s9" style="color: #962542;"><b>*Behind on Taxes:</b></span>
				</td>
				<td height="40">&nbsp;</td>
				<td height="40" colspan="2">
					<span class="s9" style="color: #000080;"><b>
                    <input type="radio" name="behindontaxes" value="yes" tabindex="530" /> YES&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<input type="radio" name="behindontaxes" value="no" tabindex="531" /> NO</b></span>
				</td>
				<td height="40">&nbsp;</td>
				<td height="40" align="right">
					<span class="s9" style="color: #000080;"><b>Total Taxes Behind:</b></span>
				</td>
				<td height="40">&nbsp;</td>
				<td height="40">
					<input type="text" name="taxesbehind" value="" size="15" tabindex="540" />
				</td>
				</tr>

				<tr>
				<td height="20">&nbsp;</td>
				<td height="20">&nbsp;</td>
				<td height="20">&nbsp;</td>
				<td height="20">&nbsp;</td>
				<td height="20">&nbsp;</td>
				<td height="20">&nbsp;</td>
				<td height="20">&nbsp;</td>
				<td height="20">&nbsp;</td>
				</tr>

				<tr>
				<td height="38" align="right">
					<span class="s9" style="color: #962542;"><b>*Price You Want:</b></span>
				</td>
				<td height="38">&nbsp;</td>
				<td height="38" colspan="2">
					<input type="text" name="askingprice" value="" size="15" tabindex="550" />
				</td>
				<td height="38">&nbsp;</td>
				<td height="38" align="right" valign="middle">
					<span class="s9" style="color: #962542;"><b>*How Soon Do You&nbsp;<br />Need An Answer:</b></span>
				</td>
				<td height="38">&nbsp;</td>
				<td height="38">
					<input type="text" name="needanswerby" value="" size="15" tabindex="560" />
				</td>
				</tr>

				<tr>
				<td height="50" colspan="8">
					<span class="s9" style="color: #000080; font-size: 14pt;"><b>OTHER INFORMATION</b></span>
				</td>
				</tr>

				<tr>
				<td height="39" colspan="8">
					<span class="s9" style="color: #962542;"><b>*How Did You Find out about us?:</b></span> 
                    <input type="text" name="referral" value="" size="48" tabindex="570"  />
				</td>
				</tr>

				</table>

				<p align="center">
					<textarea rows="3" name="otherinfo" cols="67" tabindex="580"></textarea>
				</p>
			  </td>
				</tr>
				</table>

				<br />
				<p>
                <input type="submit" value="SEND  INFORMATION  TO  RAINBOW  REALTY" style="font-weight: bold; color: #FFFFFF; background-color: #962542; font-size:16px; text-align:center; margin-left:10; margin-right:10;" tabindex="600" /><br>&nbsp;</p>
			</form>

		</td>
		<td align="right" valign="bottom" width="2%" height="1422">
			<img border="0" src="eForms/images/blank.gif" width="30" height="10" align="center">
		</td>
		</tr>

		<tr>
		<td valign="bottom" width="100%" height="1" colspan="3">
			<p align="center"><span class="s8">
Warning: Undefined array key "referral" in /users/linkuwant.com/htdocs/WeBuyHomes/eForms/Lib/form_bottom.php on line 2
<script language="JavaScript">
<!--
function My_Favorite() 
{ 
if (window.external) 
// if the browser is IE open the add favorite window
{
external.AddFavorite('http://www.WeBuyHomes.net','WeBuyHomes.net')
// Add the document location and title to the AddFavorite window
}
else 
// Display and alert box for any other browser.
{
alert("To Bookmark the WeBuyHomes.net website . . ." + 
"\nHold down the [CTRL] key   and   press the [D] key");
}
}
// -->
</script>
<div align="center">
  <center>
<table valign="top" width="100%" cellspacing="0" cellpadding="0" border="0" bgcolor="#E1DDC6" style="border-collapse: collapse" bordercolor="#111111">
<tr>
<td width="2%" height="1" rowspan="5" align="left" valign="bottom">
<p align="left">
<img src="eForms/images/Dor_blcorner.gif" border="0" align="bottom" width="9" height="9"></p>
</td>
<td width="2%" height="1" rowspan="5" align="left" valign="bottom">
<p align="center"><font size="1" face="Arial">
  <img border="0" src="eForms/images/blank.gif" width="10" height="30" align="center"></font>
</td>
<td valign="top" width="96%" height="0">
<p class="s7" align="center">
<a class="s7" href="javascript:My_Favorite()">Bookmark Website</a>
<img height="5" hspace="0" src="eForms/images/blank.gif" width="10" border="0"> 
|<img height="5" hspace="0" src="eForms/images/blank.gif" width="10" border="0">
<a class="s7" href="contact.php?domain=WeBuyHomes.net
Warning: Undefined variable $print_referral in /users/linkuwant.com/htdocs/WeBuyHomes/eForms/Lib/form_bottom.php on line 43
">Contact Us</a>
<img height="5" hspace="0" src="eForms/images/blank.gif" width="10" border="0"> 
|<img height="5" hspace="0" src="eForms/images/blank.gif" width="10" border="0">
<a class="s7" href="disclaimer.php?domain=WeBuyHomes.net
Warning: Undefined variable $print_referral in /users/linkuwant.com/htdocs/WeBuyHomes/eForms/Lib/form_bottom.php on line 46
">Disclaimer</a>
<img height="5" hspace="0" src="eForms/images/blank.gif" width="10" border="0"> 
|<img height="5" hspace="0" src="eForms/images/blank.gif" width="10" border="0">
<a class="s7" href="copyright.php?domain=WeBuyHomes.net
Warning: Undefined variable $print_referral in /users/linkuwant.com/htdocs/WeBuyHomes/eForms/Lib/form_bottom.php on line 49
">Copyright</a><img height="5" hspace="0" src="eForms/images/blank.gif" width="10" border="0"> 
|<img height="5" hspace="0" src="eForms/images/blank.gif" width="10" border="0">
 <a class="s7" href="privacy_policy.php?domain=WeBuyHomes.net
Warning: Undefined variable $print_referral in /users/linkuwant.com/htdocs/WeBuyHomes/eForms/Lib/form_bottom.php on line 51
">Privacy Policy</a>
</td>
<td width="2%" height="1" rowspan="5" align="left" valign="bottom">
<font size="1" face="Arial">
  <img border="0" src="eForms/images/blank.gif" width="10" height="30" align="center"></font></td>
<td width="2%" height="1" rowspan="5" align="right" valign="bottom">
<p align="right"><img src="eForms/images/Dor_brcorner.gif" width=9 height=8 border="0" align="absbottom">
</td>
</tr>

</table>
  </center>
</div></span>
		</td>
		</tr> 

		</table>
		</div>
		</body>
		</html>