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Name:
Street Address:
Address (Cont.):
City:
State/Province:
Zip/Postal Code:
Country:
Work Phone#:
Home Phone#:
E-Mail:
Fax#:
# of Bedrooms:
# of Bathrooms:
# of Square Feet:
Garage: Yes No
Present Housing Status:
Presently Renting Home Already Sold
Presently on Market
Preferred Housing Type:
Custom Built Home Apartment
Vacation Home Golf Course
Pre-Owned Home Homesite/Lot
Other

If other please specify:

Preferred Geographic Location:
Interior River Front
Lake Front

Preferred Community Types:
Country Club Traditional Neighborhood
Residential Resort Suburban Neighborhood
Retirement Community

Preferred School Type:
Public
Private

Preferred Mortgage Type:
VA FHA
Conventional Loan Assumption

House price interested in:

Desired monthly payment
(taxes and insurance):

Pets:

Type:

Need Temporary Quarters:

Yes No

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