Your Name (First, Last):
Address (Street Number, Street Name)
City:
State/Province, Zip:
Home Phone:
Cell Phone:
E-Mail:
Price Range:	Choose One Up To $100,000 $100,000 to $150,000 $150,000 to $200,000 $200,000 to $250,000 $250,000 to $300,000 $300,000 to $350,000 $350,000 to $400,000 $400,000 to $450,000 $450,000 to $500,000 $500,000+
Property Type:	Primary Residence Vacation Home Investment Property
Property Style:	Single Family Home Townhouse Condominium Villa Multiple Family Home Manufactured Home Mobile Home
Date Home Was Built (Oldest):
# of Bedrooms:
# of Full Bathrooms:
# of Half Bathrooms:
Approximate Heated Square Footage: (Garage, Basement, non-enclosed Porch or Lani excluded)
Lot Size / Acreage:	Choose One Up To 1/4 Acre 1/2 Acre 1 Acre 2-5 Acres 5-10 Acres 10+_Acres Unsure
Pool:	Choose One Owned Community None
Parking:	Choose One 1 Car Garage 2 Car Garage 3 Car Garage More Than 3 Car Garage Carport Parking Pad No Gargae
Property Features:	Choose one Waterfront Gated Community Golf Course Frontage
Additional Comments: (The more information you provide, the more accurate your home search will be.
When are you planning to purchase?	Right Away 90 Days 6 Months 12 Months
What city will you be moving to?

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