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R E Q U E S T A P R O P E R T Y

First Name
Last Name
Spouse (optional)
Email
Street 1
Street 2
City
State
Zip
Phone #
Work #
Best Time To Contact Me
Your comments
Items Below Are Optional:
Primary Interest: (home?)	New ResaleEither
Payment Choice:	Cash Loan Lease Unsure
Price or Payment Range:	(i.e. ,000-125,000 or -900/mo.)
Desired Location:	(i.e. Rural,Town,Beach)
Our Listing Number (if known)
Number of Bedrooms & Baths:	(i.e. 3 & 1.5 or 4 & 2)
Home Type:	(i.e. 1 story, 2 story)
Home Age Limit:	(i.e. 20years)
Options, Must Have:	(i.e. fireplace, view,beach access)
Home Purchase Date:	(i.e. within 30 days)