*Name:

*Email:

*Confirm Email:

Phone:

Fax:

Best time to contact you:

Estimated Home Value:

Year Built:

Acreage:

Style:

 Rambler
 2 Story
 3+4 Level Split
 Bi-Level Split
 Other

Walkout:

 Yes
 No

Approx. finished sq. ft. above ground:

Approx. finished sq. ft. below ground:

Number of bedrooms above ground:

Number of bedrooms below ground:

Number of bathrooms above ground:

Number of bathrooms below ground:

Age of Roof:

Age of Windows:

Type of exterior siding:

Garage:

 Attached 1 car
 Attached 2 car
 Attached 3+ car
 Detached 1 car
 Detached 2 car
 Detached 3+ car
 Carport
 None

Out Buildings:

 Yes
 No
If Yes, note size and type:

Improvements and/or upgrades:

Deck:	Yes	No
Tiled Floors:	Yes	No
Wood Floors:	Yes	No
Fireplace:	Yes	No
Paved Road:	Yes	No

View/Frontage:

 Water View
 Lakefront
 Riverfront
 Wooded Lot
 Open Lot
 Golf Course
 City Lot

Property Address:

Property City:

Property Zipcode:

Additional features or upgrades
which should be considered:

When to sell:

 Immediately
 Within 2 months
 Within 6 months
 Within 1 year
 Undecided

Do you need to find a new home?

 Yes
 No

Would you like to be on our mailing list for newsletters, just-listed notices, etc.?

 Yes
 No

Comments: