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Real Estate Needs Short Form. Basic Information
Are you buying or selling, or both?
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Buying
Selling
Both Buying and Selling
Please describe the type of Real Estate you wish to Buy:
Type of Real Estate you want to buy:
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Single Family Home
Condominium
Other
Square footage Range:
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600 - 800
800 - 1000
1000 - 1200
1200 - 1400
1400 - 1600
1600 - 1800
1800 - 2000
2000 - 2500
2500 - 3000
3000 - 4000
4000 - 5000
5000 - 6000
6000 - 8000
8000 - 10000
over 10000
Number of Bedrooms:
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1
2
3
4
5
6
7
8
9
10+
Number of Bathrooms:
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1
1.5
2
2.5
3
3.5
4
4.5
5
5.5
6+
What is the price range you wish to stay in?
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$100,000 - $124,999
$125,000 - $149,999
$150,000 - $174,999
$175,000 - $199,999
$200,000 - $224,999
$225,000 - $249,999
$250,000 - $299,999
$300,000 - $349,999
$350,000 - $399,999
$400,000 - $449,999
$450,000 - $499,999
$500,000 - $549,999
$550,000 - $599,999
$600,000 - $699,999
$700,000 - $799,999
$800,000 - $899,999
$900,000 - $1,000,000
$1,000,00 - $1,250,000
$1,250,000 - $1,500,000
$1,500,000 - $1,750,000
$1,750,000 - $2,000,000
$2,000,000 - $2,500,000
$2,500,000 - $3,000,000
$3,000,000 - $3,500,000
$3,500,000 - $4,000,000
$4,000,000 - $4,500,000
$4,500,000 - $5,000,000
$5,000,000 - $6,000,000
$6,000,000 - $7,000,000
$7,000,000 - $8,000,000
$8,000,000 - $9,000,000
$9,000,000 - $10,000,000
What is the percentage you intend to put down?
(
Tip:
The more money you can put down the lower your
payments and interest rates will be.)
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NA
0% - 5%
6% - 10%
11% - 15%
16% - 20%
21% - 25%
26% - 30%
31% - 35%
36% - 40%
41% - 45%
46% - 50%
51% - 55%
56% - 60%
61% - 65%
66% - 70%
71% - 75%
76% - 80%
81% - 85%
86% - 90%
91% - 95%
96% - 100%
Please enter at least one zip code located in the
area(s) you wish to purchase within:
To be more accurate, you may also describe the
area(s) you wish to purchase within :
(
Tip:
You may enter multiple zip codes and/or give the city
and state with county and/or neighborhood information.)
Your occupation:
How long have you been at your current job?
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less than 1 year
1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10+ years
Your Yearly Household Income:
$
What best describes your credit rating?
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Excellent
Good
Fair
Poor
Please describe the Real Estate you are selling:
Type of Real Estate you want to sell:
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Single Family Home
Condominium
Other
What is your asking price?
$
What is the minimum price you will accept?
$
Square footage Range:
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600 - 800
800 - 1000
1000 - 1200
1200 - 1400
1400 - 1600
1600 - 1800
1800 - 2000
2000 - 2500
2500 - 3000
3000 - 4000
4000 - 5000
5000 - 6000
6000 - 8000
8000 - 10000
over 10000
Number of Bedrooms:
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1
2
3
4
5
6
7
8
9
10
Number of Bathrooms:
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1
1.5
2
2.5
3
3.5
4
4.5
5
5.5
6+
Real Estate Address:
Real Estate City:
Real Estate State/Province:
ALBERTA
ALABAMA
ALASKA
ARIZONA
ARKANSAS
BRITISH COLUMBIA
CALIFORNIA
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NOVA SCOTIA
NORTHWEST TERRITORIES
NUNAVUT
OHIO
OKLAHOMA
ONTARIO
OREGON
PENNSYLVANIA
PRINCE EDWARD ISLAND
PUERTO RICO
QUEBEC
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TEXAS
UTAH
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VIRGINIA
WASHINGTON
WASHINGTON, D.C.
WEST VIRGINIA
WISCONSIN
WYOMING
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Real Estate Zip/Postal Code:
Why are you selling?
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Want larger home
Want better neighborhood
Retirement
Selling vacation home
Financial reasons
Want smaller home
Job relocation
Divorce/seperation
Selling rental home
Other
Supplemental Information:
Your Date of Birth:
(mm/dd/yyyy)
Are you moving?
Yes
No
Have you signed a contract with a real estate agent?
No
Yes
Yes, I am looking for another agent
If yes, what company is the agent with?
Not Listed or Dont Know
Abbott Realty
Advantage_pi Realty
Allen Tate Realtor
Allen Tate Realty
American Realty
Anchor Realty
Caldwell Realty
Carr Realty
Castle Realty
Century 21
Century 21 Real Estate
Century 21 Realtor
Century 21 Realty
Champion Realty
Coast Reality
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Coldwell Banker Realtor
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Coldwell Realtor
Coldwell Realty
Cornerstone Realty
Counselor Realty
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Dunes Realty
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Elliott Realty
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ERA Realtor
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Exit Realty
First Realty
First Weber Realty
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GMAC Realtor
GMAC Realty
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Keller Williams Realty
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Long And Foster Realty
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United Realty
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Weichert Realty
Windemere Realty
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Woodland Realty
Zip Realty
Are you interested in free information on a new
mortgage, refinancing, or taking cash out of your home?
(This is optional and is not required to process your
Real Estate request.)
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Yes, new mortgage
Yes, refinance mortgage
Yes, cash out refinance
No
When are you planning to buy or sell a home?
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Less than 1 Month
1 - 2 Months
2 - 3 Months
3 - 6 Months
More than 6 Months
Step 2 of 2 Finish
First Name:
By providing your information, you agree to be contacted by a local Realtor who will provide you with a free, no obligation consultation that includes:
. A market analysis of recent home sales to help you determine home values in the neighborhood in which you are interested
. A review of the services that they will provide to you as your buying agent
. Access to all current homes listed for sale
Last Name:
Primary Phone: (include area code)
Alternate Phone:
Email:
If you are selling, and you entered your home address above, click here:
If not, please fill out your address below:
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Zip/Postal Code:
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