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Required Fields *
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First Name : |
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Last Name : |
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E-mail: |
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Address: |
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City: |
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State: |
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Zip Code: |
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Phone Number: |
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Alternate Phone Number: |
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Fax Number: |
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General Information About Your Move |
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Are you relocating from another city?
Yes
No |
If Yes where are you moving to? |
City: |
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State: |
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Zip : |
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When do you anticipate the purchase of your new home? |
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| Type of Home: |
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Single Family |
Condo/Townhouse |
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Multi-Family |
Mobile Home |
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Farm |
Land Only |
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Approximate price range: |
to
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Number of Bedrooms: |
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Number of Bathrooms: |
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| Interior Features: |
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| Living Room: |
Yes
No |
Family Room: |
Yes
No |
| Fireplace: |
Yes
No |
Hardwood Floors |
Yes
No |
| Den / Study: |
Yes
No |
Laundry Room: |
Yes
No |
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| Other Important Interior Features: |
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| Exterior Features & Preferences: |
| Swimming Pool: |
Yes
No |
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Spa: |
Yes
No |
| Waterfront: |
Yes
No |
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Garage: |
Yes
No |
| Tile Roof |
Yes
No |
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Fenced: |
Yes
No |
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| Other Important Exterior Features: |
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Additional Information: |
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| Have you ever been pre-qualified for a mortgage?
No
Yes |
| If Yes, for how much?
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If Yes, With What Company?
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| Are you currently working with a realtor?
No
Yes |
If Yes, Who?
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| Do you have a down payment?
No
Yes |
| If yes, what is your maximum commitment?
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| Any other comments: |
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