Real Estate Agent- Buyer's Referral Form
Where would you like your new home to be located in?
Do you currently rent or own your home?
Rent
Own
How many in your household?
1
2
3
4
5
6+
What is your price range?
Under $150,000
$150,000 - $250,000
$250,000 - $350,000
$350,000 - $450,000
$450,000 - $550,000
I don't know
What is your desired Monthly Payment
What is your estimate household monthly income?
under $5,000
$5,000 - $7,500
$7,501 - $10,000
over $10,000
What is your Credit Score?
Excellent (720+)
Good (680-719)
Fair (620-679)
Poor (Below 620)
I don't know
Do you or a co-borrower work in any of the following professions?
Law Enforcement
Educator
Health Care Worker
Fire Fighter
If you qualify and could find the perfect home, how soon would you like to make a move?
ASAP
1-3 Months
3-6 Months
6+ Months
What is your email address?
example@example.com
What is your name?
First Name
Last Name
Where can we text your confidential results?
-
Area Code
Phone Number
Save
Submit
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