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<TITLE>Submit your House for purchase</TITLE></head>
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                                                                 <a href="index.html" onMouseOver="document.images['img8'].src='widgets/gen_148.1.gif'" onMouseOut="document.images['img8'].src='widgets/gen_147.1.gif'"><img src="widgets/gen_147.1.gif" alt="Home" name="img8" border="0"></a><br>
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<center><table border="0"><tr><td>


<font face='Arial' size='+1' color='#572510'>

Submit your House for purchase

</font>


<br>
<SCRIPT LANGUAGE="JavaScript">
function validate(){
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if (document.forms[0].field_35.value==""){ valid=false; };


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if (valid==false) {
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return valid;
}
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<input type="hidden" name="user_id" value="1766963">
<input type="hidden" name="title" value="Submit your House for purchase">

<input type="hidden" name="name" value="email.html">


<input type="hidden" name="order" value="27 28 29 38 30 31 32 37 33 34 35 d36 39 40 41 ">
<input type="hidden" name="submit_url" value="http://65.254.68.216/onsubmit.html">
<input type="hidden" name="error_url" value="http://65.254.68.216/onerror.html">
<table border="0">

<input type="hidden" name="name_27" value="Your First Name is">
<tr><td>


<font face='Arial' size='2' color='#000000'>

Your First Name is

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<input type="text" name="field_27">


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<input type="hidden" name="name_28" value="Your Last Name is">
<tr><td>


<font face='Arial' size='2' color='#000000'>

Your Last Name is

</font>


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<input type="text" name="field_28">


</td></tr>

<input type="hidden" name="name_29" value="Street Address of the property is">
<tr><td>


<font face='Arial' size='2' color='#000000'>

Street Address of the property is

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<input type="text" name="field_29">


</td></tr>

<input type="hidden" name="name_38" value="Unit #">
<tr><td>


<font face='Arial' size='2' color='#000000'>

Unit #

</font>


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<input type="text" name="field_38">


</td></tr>

<input type="hidden" name="name_30" value="City of the property is">
<tr><td>


<font face='Arial' size='2' color='#000000'>

City of the property is

</font>


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<input type="text" name="field_30">


</td></tr>

<input type="hidden" name="name_31" value="State of the property is">
<tr><td>


<font face='Arial' size='2' color='#000000'>

State of the property is

</font>


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<input type="text" name="field_31">


</td></tr>

<input type="hidden" name="name_32" value="Zip code of the property is">
<tr><td>


<font face='Arial' size='2' color='#000000'>

Zip code of the property is

</font>


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<input type="text" name="field_32">


</td></tr>

<input type="hidden" name="name_37" value="Type of Property you are selling is">
<tr><td>


<font face='Arial' size='2' color='#000000'>

Type of Property you are selling is

</font>


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<input type="text" name="field_37">


</td></tr>

<input type="hidden" name="name_33" value="Home phone # is">
<tr><td>


<font face='Arial' size='2' color='#000000'>

Home phone # is

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<input type="text" name="field_33">


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<input type="hidden" name="name_34" value="Work or Cell Phone # is">
<tr><td>


<font face='Arial' size='2' color='#000000'>

Work or Cell Phone # is

</font>


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<input type="text" name="field_34">


</td></tr>

<input type="hidden" name="name_35" value="E-Mail Address">
<tr><td>


<font face='Arial' size='2' color='#000000'>

E-Mail Address

</font>


 <font color="red" size="-1">*</font></td><td>


<input type="text" name="field_35">


</td></tr>

<input type="hidden" name="name_36" value="The Date your would like to move before is">
<tr><td>


<font face='Arial' size='2' color='#000000'>

The Date your would like to move before is

</font>


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<select name="field_m_36" size="1">
<option>Jan
<option>Feb
<option>Mar
<option>Apr
<option>May
<option>Jun
<option>Jul
<option>Aug
<option>Sep
<option>Oct
<option>Nov
<option>Dec
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<select name="field_d_36" size="1">
<option>1<option>2<option>3<option>4<option>5<option>6<option>7<option>8<option>9<option>10<option>11<option>12<option>13<option>14<option>15<option>16<option>17<option>18<option>19<option>20<option>21<option>22<option>23<option>24<option>25<option>26<option>27<option>28<option>29<option>30<option>31
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<input type="text" name="field_y_36" size="4" maxsize="4">


</td></tr>

<input type="hidden" name="name_39" value="The reason I am selling the property is">
<tr><td>


<font face='Arial' size='2' color='#000000'>

The reason I am selling the property is

</font>


 </td><td>


<textarea name="field_39" rows="4" cols="30"></textarea>


</td></tr>

<input type="hidden" name="name_40" value="I estimate the Present Value of the property  to be $">
<tr><td>


<font face='Arial' size='2' color='#000000'>

I estimate the Present Value of the property  to be $

</font>


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<input type="text" name="field_40">


</td></tr>

<input type="hidden" name="name_41" value="I currently have the property listed with a Real Estate Agent">
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<font face='Arial' size='2' color='#000000'>

I currently have the property listed with a Real Estate Agent

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 <font color="red" size="-1">*</font></td><td>
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<font face='Arial' size='2' color='#000000'>

True

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</label> <input type="radio" name="field_41" id="field_412" value="False"><label for="field_412">


<font face='Arial' size='2' color='#000000'>

False

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</label>


</td></tr>

</table>


<input type="submit" onClick="return validate()"> <input type="reset">

</form>
</td></tr></table></center>
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<br>
<FONT FACE="verdana, arial, helvetica" SIZE="1">
<center>
<nobr>|<a href="index.html">Home</A>|</nobr>

<nobr>|<a href="faq.html">FAQ</A>|</nobr>

<nobr>|Sell you house |</nobr>

<nobr>|<a href="profile.html">Rent 2 Own</A>|</nobr>

<nobr>|<a href="gpage.html">Stop Forclosure</A>|</nobr>

<nobr>|<a href="about1.html">Testimonials</A>|</nobr>

<nobr>|<a href="faq1.html">Homes 4 Sale</A>|</nobr>
</center>
</font>

</TD>
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<center><table border="0" cellpadding="0" cellspacing="3"><tr><td align="center">

<br><font face="helvetica,verdana, arial" size="1">&nbsp;</font>

</td></tr></table></center>
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