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First Name: Last Name: Spouse/Significant other: Number of Children:
 
Address: Suite/Apt.: City:   State: Zip:  
 
Phone: Cell: Email: Interest:  
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TELL ME ABOUT THE HOME YOU ARE LOOKING FOR
Bedrooms: Baths:   Square Ft.: Stories: Garage: Detached/Condo:   Age of Home:
   
Area/Neighborhood:   Other requirements:
Budget/Price Range: Cash Available: Max payment: Pre-qualified?  Amount? Name of Lender/Rep: Lender Phone?  
 
To help me help you, please describe your perfect home:
   
When is the best time for you to look at property?:    
 


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