Form

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Are you currently working with a Realtor

Are you a first-time homebuyer?

ARE YOU EMPLOYED?

How long have you been employed there?

When are you looking to purchase a home?

Estimated credit score:

Do you currently rent or live with family?

How much do you pay monthly for rent?

How much Money do you have to contribute to your down payment and closing cost? Note: You can include funds from a 401K

Interested in down payment assistance?

Preferred Method of Contact

Best time to contact you:

Additional Information you would like to share

How did you hear about us?

Please give reference of any two people in your circle or family that are considering purchasing or selling a home

Rows	Name	Phone	Email
Referral #1
Referral #2

Lead Disclaimer

Thanks for taking the first step! I’ll reach out shortly to discuss your home buying goals.

✨ LaTisha Leverson, Realtor® | TN & MS Licensed
BenchMark Realtors, LLC
📱 Cell: 901-297-9560
📞 Office: 901-692-9253
📧 Email: leversonlrealty@gmail.com

🌐 Website: latisha.leverson@benchmarkrealtors.com

🏡 Serving Memphis, Shelby County & DeSoto County — TN & MS
🔑 #LevelUpWithLaTisha