Boxes with * must be filled in.
I am interested in purchasing property in:

City*

State/Province*

Country* 

Preferred areas, neighborhoods or counties:

 

Please tell us about you:

E-Mail Address *

First Name *

Last Name *

Address

Apt. Or Suite Number

City

State/Province

Country 

Zip/Postal Code

Daytime phone *

Evening phone

Property Type: *

 

 

Single Family Home
Multi-Family Home
Condo/Town home
Second Home

Land Only
Farm/Ranch Property
Investment Property
Commercial Property

Other (Please Specify):

Minimum number of bedrooms 
1 bedroom
2 bedrooms
3 bedrooms
4 or more bedrooms

Minimum number of bathrooms
1 bathroom
2 bathrooms
3 or more bathrooms

Approximate Price Range: *

Under $100,000
$100,000 to $125,000
$125,000 to $150,000
$150,000 to $200,000
$200,000 to $250,000
$250,000 to $300,000

$300,000 to $400,000
$400,000 to $500,000
$500,000 to $600,000
$600,000 to $1 million
Over $1 million

Other (Please Specify):

When are you going to buy:

As soon as possible
1 to 3 months
3 to 6 months

6 to 12 months
When present home is sold
Undecided

If this is a work-related move (relocation) please check one:
Company relocation
New Job
Considering moving and need more information


Are you Qualified or Pre-Qualified for a mortgage?
Pre-Qualified
Qualified (loan is fully approved)
Have not applied for a mortgage yet
No mortgage needed
Please send me mortgage information.

Is there anything else you would like to tell us?

I am a real estate agent seeking an exclusive buyer agent for an out of service area referral.