Let a professional real estate agent find the perfect home for you. REALTORS ® are privy to new homes on the market prior to being found on the Internet. Fill out this form for a customized search for your new home today.
	Name (required):   E-mail (required):   Address:   City:   State:   AK AL AR AZ CA CO CT DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zipcode:   Day Telephone:   Evening Telephone:   Fax:
	General Information About Your Move
	Are you relocating?   Yes    No     Where are you moving?     City:   State:   AK AL AR AZ CA CO CT DE FL GA HI IA ID IL IN KS KY LA MA MD MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zipcode:
	When do you anticipate purchasing your new home? within 4 months within 6 months within a year no date set
	Information About The Home You Are Looking For
	Type of Home:
	Single Family Condo/Townhouse Multi-family Mobile Home Farm Land Only
	Approximately priced between: 50,000 75,000 100,000 150,000 200,000 300,000 400,000 500,000 1,000,000 1,000,000+ and 50,000 75,000 100,000 150,000 200,000 300,000 400,000 500,000 1,000,000 1,000,000+
	Number of Bedrooms: 1   2   3   4   5   6+
	Number of Bathrooms: 1   2   3   4+
	Interior Features & Preferences:
	Living Room Yes    No Family Room Yes    No Fireplace Yes    No Hardwood Floors Yes    No Den / Study Yes    No Laundry Room Yes    No
	Other Important Interior Features:
	Exterior Features & Preferences:
	Swimming pool Yes    No Spa Yes    No Waterfront Yes    No Garage Yes    No Tile roof Yes    No Fenced Yes    No
	Other Important Exterior Features:
	Additional Information
	Have you ever been pre-approved or pre-qualified for a mortgage?
	No  Yes   If yes, for how much?
	Do you have a down payment?
	No  Yes   If yes, what is your maximum commitment?
	Have you had a credit report done lately?
	No  Yes  If yes, any problems?  Yes  No
	Please use this space for any other comments or questions you might have.