Name

Email Address

Mailing Address

Home Phone (Please Include all International Calling Codes)

Best time to call at home

Work Phone (Please include all International Calling Codes)

Best time to call at work

Area Desired

Fort Stewart Area Hunter Army Airfield Area Coastal Georgia Richmond Hill Area Savannah Area

When do you need your new home?

When Current Home Sells Immediately 1 Month 2 Months 3 Months 4 to 6 Months 6 to 8 Months 9 to 12 Months More Than 12 Months

Are you currentlly working with a Realtor to buy a property?

Yes No

Price Range Desired

Not Buying - Interested in Renting Less Than $100,000 $100,000 to $150,000 $150,000 to $200,000 $200,000 to $250,000 $250,000 to $300,000 Over $300,000

Type of Property Desired

Single Family Duplex Townhouse / Condominium Apartment Commerical Property Other

When do you plan to sell your current home?

Currently Renting Buying Additional Home Immediately 1 Month 2 Months 3 Months 4 to 6 Months 6 to 8 Months 9 to 12 Months More Than 12 Months

Is your current home listed with a Realtor?

Yes No

May a Realtor contact you concerning listing your current home?

Yes No

Is your relocation employment related?

Yes No

If employment related, name of employer

Driving distance from employment desired

Please Choose Distance 5 miles or less 10 miles or less 15 miles or less 20 miles or less 25 miles or less 50 miles or less

What are you financing requirements?

Mortgage Not Needed Please Have Lender Contact Me Pre-Qualified Pre-Approved In Process VA Loan USAA

Additional Comments