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BUYING? LET US HELP. Indicate your new home requirements, tell us about yourselves, and we will swing into action to find you the home you are looking for. For our clients: Click here if you'd like to receive daily or weekly home listings via e-mail that match your criteria. Your Name:   Address:   City/State:   GA AK AL AR AZ CA CO CT DC DE FL 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 Zip Code:   Home PHONE:   Work PHONE:   FAX Number:   E-MAIL Address:   CURRENT STATUS. Do Your Presently: OWN RENT If Renting, Date Lease Expires: Is Your Home Currently on the Market? YES NO REQUIRED OCCUPANCY DATE. MONTH JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER DATE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 YEAR 2001 2002 Number of People in Household: Childrens Names. (1) BIRTHDATE : (2) BIRTHDATE : (3) BIRTHDATE : Reason for Selling Your Home. LOCAL TRANSFER Corporate Assistance in Relocation? YES NO Employed by: How Many Bedrooms Do You Require? How Many Bathrooms Do Your Require? PRICE RANGE. $100,000-$150,000 $150,000-$250,000 $250,000-$500,000 $500,000+ GENERAL DESIRED LOCATION: TYPE OF HOME. Contemporary Traditional Ranch Split Level Two-Story BASEMENT. Full Partial Slab/Crawl AGE OF HOME. New Home 1-5 Years 5 Years or More ADDITIONAL COMMENTS. Would You Like Us to Have a Mortgage Banker Contact You? YES NO

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