* Type of Residence: Select Here Primary_Home Rental_Property Secondary_Residence Prospective_Home Other
* Type of Home: Select Here Single_Family_Home Condo Multi-Family_Home Townhouse Manufactured_Home Mobile_Home
* Relationship To Home: Select Here Legal_Owner Landlord Renter Potential_Buyer Other
* How Long Have You Owned This Home: Select Here Less_Than_One Year One_To_Three_Years Three_To_Five_Years Five_To_Seven_Years Seven_To_Ten_Years Ten_To_15_Years 15_To_20_Years 20_To_30_Years 30_Or_More_Years I_Am_Not_The_Owner
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Neighborhood Name:
Name of Builder:
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* Levels of Home: Select Here Single_Level Two_Story Bi-Level Tri-Level Other
* Bedrooms: Select Here 1_Bedroom 2_Bedrooms 3_Bedrooms 4_Bedrooms 5_or_More
* Full Bathrooms: Select Here 1_Full_Bath 2_Full_Baths 3_Full_Baths 4_Full_Baths 5_or_More
* Half Bathrooms: Select Here 1_Half-Bath 2_Half-Baths 3_Half-Baths 4_or_More None
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* Approx. Square Footage:
(Not Including Basement Or Garage.)
* Basement: Select Here Finished Partial_Finished Unfinished No_Basement
* Garage: Select Here 1_Car 2_Cars 3_Cars 4_or_More No_Garage
* Home Cooling: Select Here Central_Air Window_Unit(s) None Other
* Home Heating: Select Here Gas_Forced-Air / Other Electric_Forced-Air Electric_Other Don't_Know Other
* Approx. Year Built:
School District:
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* Lot Size: Select Here Less_Than_1/2_Acre 1/2_to_3/4_Acre 3/4_to_1_Acre 1_to_1.5_Acres 1.5_to 2_Acres 2_or_More_Acres
* Homes Condition: Select Here 1_Poor 2 3 4 5 6 7 8 9 10_Excellent
* Planning To Sell: Select Here Right_Away Within_1 - 3_Months Within_3 - 6_Months Within_6 - 12_Months Not_Within_12_Months I_Want_To_Buy
* Todays Month & Day: Month Here JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER & Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
* Is Your Home On The Market ? Select Here Yes_With_An_Agent Yes_By_Owner No
* Your Home's General Price Range: Select Here Under $100,000 $ 100,000 to 150,000 $ 150,000 to 200,000 $ 200,000 to 250,000 $ 250,000 to 350,000 $ 350,000 to 500,000 $ 500,000 to 750,000 $ 750,000 to 1,000,000 $ 1,000,000 and up
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* Do You Work In The Real Estate Industry ? Select Here Yes No
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Referred By:
(Optional)
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Tell us more about your home:

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