Client Information for Real Estate

Client Information for Initial Real Estate Consultation

Please complete all questions.
Name*

First NameMiddle NameLast Name
E-mail*
example@example.com
Contact Phone Number
Format: (000) 000-0000.
1099W2
Credit Score: Ex.620
Where do you work? Place
How long have you worked on with this employer?
Ex. 1 year or x months
Annual Income :
$
YesNo
Do you currently Rent or Own?
If you answered Yes, on the previous question, How much is your current rent? Montly Amount
YesNo
YesNo
YesNo
Appointment:
- Locations Interested In
  Cities, Towns, Counties, Areas
- # of Bedrooms
- # of Bathrooms
- When would you like to move in?
  Date
- Price Range $
- Desired Maximum Montly Payment
- New ConstructionRe-sale/ Used House
- Single Family HomeTownhomeApartmentOther
- Please share any additional requests or information you would like me to know about you or your preferences:
- Please share the address and any valuable information about your property along with the reason for selling it:
- Should be Empty:

Client Information for Initial Real Estate Consultation