Name:*
Address:*
City:*
State & Zip Code:*
Current Occupation/Business:
Home Phone:
Work Phone:*
Cell Phone:*
Fax:
Email:*
How did you hear about our firm? Advertisment Referral Yellow Pages Internet Other:
Type of Real Estate Preference: 1. 2. 3.
Location Preference: 1. 2. 3.
Amount of cash available for down payment:
Date it will be available:
Approximate date you wish to take possession:
Your personal or business estimated Net Worth:
Who, besides yourself will be involved in the decision?
Are you a U.S. Citizen? yes no
Question/Comments:
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