First Name* Last Name*

Address City

State Zip

Phone* Email*

Property Type* Single Family New Home Construction Condominium/Townhouse Mult-family Commercial Property Square Feet Unknown ‹ 1000 1000-1500 1500-2000 2000-2500 2500-3000 3000-3500 3500-4000 4000-4500 4500-5000 5000-5500 5500-6000 6000-6500 6500 +

# of Bedrooms 1 2 3 4 5 + # of Bathrooms 1 2 3 4 5 +

Garage Size* 1 car 2 car 3 car 4 car RV Garage Garage Depth* 22’-27’ 28’-32’ 33’-36’ 37’-40’ 41’-45’ 46’-50’ over 50’

Pool No Yes

When do you want to move? Unknown 1 Month 2 Months 3 Months 4 Months 5 Months 6 Months 7 Months 8 Months 9 Months 10 Months 11 Months 12 Months +

How long have you been looking? Less than 30 days 1 Month 2 Months 3 Months 4 Months +

Are you currently working with an agent? Yes No

Have you been prequalified? Yes No

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