P l e a s e   F i l l   O u t   T h i s   F o r m

First Name:

Last Name:

Address:

City, State & Zip:

Telephone:

E-mail:

Are you interested in...
Buying? Selling? -OR- Leasing?

What Is Your Price Range?

Special Features Your Home Has (or you require)

Complete all that apply:
Ranch
1 1/2 story
2 story
Condo
Multi-family
Vacant land
Investment
Built on ( basement crawl slab)
Garage Size ( # of cars )
Minimum # of Bedrooms
1st floor bedroom
Formal dinning room
Den
City water
City sewers
Lot size (acres )
Area (city )
Type of financing ( cash conventional f.h.a v.a other)
Water front
Canal
Other

When Would You Like To Move?

Other Comments or Questions:

T h a n k    Y o u !