Real Estate Buyer Information Request Form

Send To: * Nick Ladd (Office Manager) Megan Jefferson (Realtor) Henry Cabrera (Realtor) Sam Peterson (Mortgage Broker) Kendra Carlson (Mortgage Broker) Your Name: * E-mail Address: * Home Phone: * Business Phone: Mobile Number: Street Address: City: State: AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY -Terr.- AS FM GU MI PR VI Zip Code: Do you have a preferred school district? Do you currently own or rent? Own Rent Other What is your time frame for moving? Select OneWithin One WeekTwo Weeks or LessWithin One Month1 - 2 Months2 - 6 MonthsWithin One YearNot Sure How many bedrooms do you need? 1 2 3 4 5+ How many bathrooms do you need? 1 1 1/2 2 2 1/2 3 Do you require covered parking? Yes No If so, what type? Select One1 Car2 Car3 Car or LargerCarportDetached GarageAttached Garage Are you looking for any special features in a new home? What price are you considering? Have you been approved for a mortgage? Yes No Do you need to sell a home before you buy? Yes No Any other comments regarding your home search? Verification Code: Enter Verification Code: * * Required

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