| Name: |
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| Home Phone#: |
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| Cell #: |
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| Fax #: |
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| Email Address: |
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| Best time to contact you? |
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| Type of Property (check all that apply): |
Detached Single Family |
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Custom |
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Ranch |
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2 Story |
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Townhouse |
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Duplex |
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Triplex |
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Fourplex |
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Condominium |
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Cooperative |
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PUD |
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Land |
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Retirement Community |
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Vacation Home |
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Other |
| Number of Bedrooms: |
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| Number of Bathrooms: |
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| Square Footage of House: |
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| Lot Size: |
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| Property Address: |
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| Property City: |
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| Zip Code: |
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| Check all that apply: |
Family Room |
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Formal Dining Room |
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Basement, Finished |
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Basement, Partial |
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Wine Cellar |
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Guest House |
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Basement, Full |
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Pool or Spa |
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Fireplace |
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Laundry Room |
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Den/Office |
| Air Conditioning: |
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| Heating System: |
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| View: |
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| Garage: |
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| Additional features or upgrades which should be considered: |
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Do you need to find a new home? |
| When do you need to sell? |
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| Comments: |
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