Untitled Document
Agent
First Name
Middle Name
Last Name
Full Legal Name
Date of Birth
Mobile Phone
Preferred E-mail Address
Home Address
Street 1
Street 2
City
State/Region
Postal Code
Country
Type of Flooring Desired?
Number of Fireplaces
Number of Dining Areas
Work Phone
Home Phone
Square Foot Range
Year Built Range/Type
What is your desired price range?
What areas are you most interested in? (cities, school districts, subdivisions, ect)
To what locations do you commute?
What driving time is acceptable?
Number of Garage Spaces
What is the likely amount of your down payment (both $ and %)?
Monthly mortgage payment range (includes principle, interest, taxes & insurance - PITI)
Are you a veteran of any kind?
Other considerations
Type of Home
Number of Bedrooms
Number of Full Baths
Number of Half Baths
Number of Living Areas
Number of Garage Spaces
Number of Stories
Condition
Other people living at home (ages, if children)
Pets the home must accommodate
Hobbies
What do you like about your current home?
What do you dislike about your current home?
What special features are you looking for?
Is this your first home purchase?
When would you like to move into your new home?

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