Name:*

Email:*

Phone Number: * (XXX) XXX-XXXX

Best time to Call: (example: weekdays 9-5pm)

Fax Number: (XXX) XXX-XXXX

Min. $:   Max. $:

Location/Area:

Age of Home: Not Important New less than 10 years less than 25 years less than 40 years more than 40 years

Minimum Number of Bedrooms: Not Important 2 3 4 5 More

Minimum Number of Bathrooms: Not Important 1 1.5 2 2.5 3 3.5 4 More

Pool: Not Important Yes No

Heating: Not Important Gas Oil Electric Infrared Other

Family Room: Not Important Yes No

Finished Basement: Not Important Yes No

Parking Type: Not Important Attached Garage Detached Garage Driveway Stall Street Other

Parking Spaces: Not Important 1 2 More than 2

Approximate Lot Size: Not Important Standard Oversized 0.5 Acres 1 Acre More than 1 Acre

Preferred Style of Home: Not Important Single Family/Home Attached Condo Apartments Condo Townhouse Duplex Multi Family Investment Property Recreational Property Rural Time Share Vacant Lot/Land Other

Type of Property: Not Important 1 and Half Story 2 and Half Story 2 Story 2 Story Split 3 Level Split 4 Level Split 5 Level Split Back Split Bi-Level Bungalow Double Wide Mobile Home Hillside Bungalow Loft Modular Home Multi Level Apartment Not Applicable Penthouse Recreational Use Single Level Apartment Single Wide Mobile Home Villa

Would You Like Mortage Info?: Yes   No

Do You Currently Own or Rent?: Own   Rent

Are You Working With a REALTOR®?: Yes   No