Please Fill out the form completely.
I do not give out or release any of your information!
First Name:
Last Name:
Mailing1:
Residence
Business
Mailing2:
City:
State:
Zip:
Phone:
Fax:
e-Mail Address:
Website:
How did you hear about me?
Select Here
Referred by Existing Customer? WHO
You already bought from me? WHEN
An Advertisement? WHERE?
A Website? WHICH
Deatils:
Please fill in the requested items:
Max Price:
Minimum Bedrooms?:
Minimum Bathrooms?:
Minimum square footage?:
How many garage spaces?:
Single story?
What Towns would you like?:
Sewer-Septic
HOA OK?:
Site-built
Choose
Yes
NO
Doesn't Matter
Age of House?:
Other important information?:
Do you have to sell your existing home or other home prior to purchasing?:
Select Choice Here
Yes
NO
What will be your net profit from that sale:
Comments:
Lender Information.
Have you talked to a lender yet?:
Select Choice Here
Yes
NO
If yes, what is their contact information?:
Name
Company
Phone Number (+AreaCode):
City& St of Lender
Did you submit the requested documents?:
Select
Yes
NO
Approved for how much?