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Your Contact Information
*First Name
*Day Phone
Example: 123 456-7890
*Last Name
Evening Phone
Address
Cellular/Pager
City
*Email
State
Zip
Best Time to Call
Your Property Needs
What's the most you can afford to pay monthly for your new home?
What's the most you can afford to put down on your home?
What price range house are you looking for?
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How is your credit? Ugly is OK!
How soon are you looking to purchase your next home?
In which area(s) do you wish to purchase your home?
How many bedrooms do you require?
How many bathrooms do you require?
How many square feet do you require?
Do you require a garage?
Do you require a basement?
Do you have any other special requirements?
*How did you hear about us?
Do you have any additional questions or comments?
What property or properties are you interested in?
