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Contact Information
Name
Email Address
Fax Number
Phone Number(s)
Best time to contact you
Housing Information
Area (Please list cities, counties, and/or general area)
Price Range
Type of property	Single Family Residential or Condo Multi-Family Vacant Lots/Land Farm/Agricultural Commercial Vacation/Lake Home Other
Size of lot/acreage	<1/2 Acre 1/2-1 Acre 1-3 Acres 3-10 Acres >10 Acres
Number of bedrooms
Number of bathrooms
School(s) desired
Additional Preferences	New Construction (never lived in) Newer Home (1-5 yrs) Older Home (>5 yrs.) Fixer-Upper Garage Fireplace Water Accessible
Other Preferences (Please Specify...)
Essential Items (Please Specify...)
When to purchase	Immediately Within 6 Months Within 1 Year Undecided
Are you working with another agent?	Yes No
Need to sell your present home	Yes No N/A - (currently renting/other)
Is your present home currently on the market?	Yes - FSBO YES - listed with another agent No
Prequalified by lender	Yes No
Need more information on financing	Yes No
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