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First Name

Last Name

Phone Number

Email Address

Do you currently own or rent? Currently Own Currently Rent

Are you currently working with a realtor? Yes No

Price Range $ 25 000 50 000 75 000 100 000 125 000 150 000 175 000 200 000 225 000 250 000 275 000 300 000 325 000 350 000 375 000 400 000 425 000 450 000 475 000 550 000 500 000 600 000 650 000 700 000 750 000 800 000 850 000 900 000 950 000 1 000 000 1 500 000 2 000 000 to $ Unlimited 25 000 50 000 75 000 100 000 125 000 150 000 175 000 200 000 225 000 250 000 275 000 300 000 325 000 350 000 375 000 400 000 425 000 450 000 475 000 550 000 500 000 600 000 650 000 700 000 750 000 800 000 850 000 900 000 950 000 1 000 000 1 500 000 2 000 000

Preferred Type of Home House Apartment/Condo Row/Townhouse Land Commercial

Area

Bedrooms 1 1 or more 2 2 or more 3 3 or more 4 4 or more 5 5 or more

Baths 1 1 or more 2 2 or more 3 3 or more 4 4 or more 5 5 or more

I plan to move in Less than 6 months More than 6 months

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