Southwest Florida Properties - Vacant Land Seller Information Form

Betty Prokos
Century 21 Sunbelt, Inc.
101 Taylor Rd.
Punta Gorda, Fl. 33950
Toll-Free Line: 800- 749-7591
Local: 941-255-9144 / Fax: (509) 752-0810
Email: betty@swfloridaproperties.net

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Your Contact Information:

*required field

*Name:

*Address:

Address Line 2:

*City:

*State:

*Country:

*Zip or Postal Code:

(no dashes or spaces)

*Day Telephone:

(no dashes or spaces)

Evening Telephone:

(no dashes or spaces)

*Email Address:

Property Legal Description:

*Lot#:

*Block#:

*Section#:

*Tax I.D.#:

(no dashes or spaces)

*County:

*Owner of Record:

*Would you like the property's current market value?:

Yes
No

How soon do you need to sell your property?

How did you hear about us?

Comments or Questions:

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