Name:
E-Mail:
Phone:
Address:
City:
State:
Zip:
Have you signed a Buyer Agency Agreement with a Realtor?	Yes ---- No
Do You own or rent your present home?	Own ---- Rent
Do you have to sell your present home before buying?	Yes ---- No
Years at present address?	Less than 1 yr ---- 1-3 years 3-5 years ----5 or more
Preferred home style?	Ranch ---- Split Level Multi-level ---- 2-Story Condo ---- Duplex
Number of Bedrooms?	1 ---- 2 3 ---- More than 3
Number of Bathrooms?	1 ---- 2 3 ---- More than 3
Number of garage spaces?	1 ---- 2 3 ---- More than 3
Other features important to you!
Price Range?
Are you pre-approved for a home loan?	Yes ---- No
Is there a specif bank or mortgage company you would prefer to work with?