The information in this questionnaire is strictly confidential.
*First Name:		*Last Name:
Spouse's Name:
Address:
Suite/Apt:
City:		State:	-- Select State -- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip:		Home Phone:
*Day Phone:		Fax:
Cell Phone:		*Email:
Situation:	-- Choose an Option -- I am in my 45-day period. My property is up for sale. I am considering whether or not to sell. My property is under contract. Investor - Non-1031 Buyer. Investor - Individual trust, etc. Investor - IRA, Pension, etc.
	*Are you a real estate agent?    Yes No
Requested Info:
	*How did you first hear about us?
	-- Choose an Option -- Discount1031Exchange.com Representative From a Friend Google.com Yahoo.com Superpages.com Other Search Engine Newspaper Magazine Mail Advertisement Professional Referral Trade Show Other
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Disclaimer: As a Qualified Intermediary we cannot and do not give legal and tax advice or tax planning assistance. However, we are experts in the procedural framework of Internal Revenue Code §1031, and our services include the preparation of all documentation necessary to complete a 1031 exchange and to ensure that your 1031 exchange complies procedurally with the rules of the IRS Code. If your question is one seeking advice or tax strategy planning we ask you to consult your Tax Attorney, CPA, or Financial Planner. Thank you.