First Name $firstname	Last Name: $lastname
Home Phone: $homephone	Work Phone: $workphone
Cell Phone: $cellphone	Email: $email
Comments: $comments
Address: $address
City: $city	State: $state	Zip: $zip
County: $county
# of Bedrooms: $bedrooms	# of Bathrooms: $bathrooms
Approximate Sq. Footage: $sqfoot	Basement: $basement
Carport: $carport	Garage: $garage
Lot Size: $lot	Stories: $stories
Age of Home: $age	Is home occupied: $occupied
Is home listed with realtor: $listed	Monthly Mortgage Payment: $payment
Estimated Home Value: $value	Estimated Repairs Needed: $repairs
1st Mortgage Payoff Amount: $mortgageone
2nd Mortgage Payoff Amount: $mortgagetwo

"; # //if(mail($to,"Contact Information",$message,"From: $email\n")) { # //header("Location:/confirmation.html"); # //} else { #// echo "There was a problem sending the mail. Please check that you filled in the form correctly.";/ #// } print $message; ?>