Interesting in buying a home or commercial property? Fill out this simple questionnaire.
First Name:
Last Name:
Street Address:
City, State, Zip:
Daytime Telephone Number / Best Time To Call:
Evening Telephone Number / Best Time To Call:
Birthday:
Email:
Occupation:
Present Salary:	$25,000 - $50,000 $50,000 - $100,000 $100,000 - $100,000 +
Number of Years Employed:
Employers Name:
Employers Street Address:
Employers City, State and Zip:
Email:
Do You Currently Own Or Rent?	Own_____ Rent
Preferred Move-In Date:	January February March April May June July August September October November December 2005 2006 2007 2008 2009 2010
Number of Household Members:	1 2 3 4 5 6 7 8 9 10 10+
Number of Adults:	1 2 3 4 5 6 7 8 9 10 10+
Number of Children:	0 1 2 3 4 5 6 7 8 9 10 10+
Price Range:	$100,000 - $150,000 $150,000 - $300,000 $300,000 - $500,000 $500,000 - $800,000 800,000 - $1,200,000 $1,200,000 +
Desired Location:
Desired Building:
Type of Property:	Condo Co-Op Townhome Single-Family Multi-Family Land Investment
Size:	Studio 1 bedroom 2 bedrooms 3 bedrooms 4 bedrooms 5 bedrooms
Number of Baths:	1 bathroom 2 bathrooms 3 bathrooms
Number of Parking Spaces:	1 outside 2 outside More than 3 outside 1 indoor More than 3 indoor
How did you Hear About Smart-Realty?	Other Google / other search engine Print Advertisement Billboard Referal
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