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* What is the ZIP code of the home you are selling? *When would you like to hire me as your Real Estate Agent? Select One Timing is flexible Now 1-3 months 4-6 months 6-9 months 9-12 months Next Year *Do you need financing? Yes No *Are you currently under contract with a Real Estate Agent? Yes No Contract has been terminated Contract is expiring soon Agent and I have agreed to terminate contract I want to interview agents in preparation for contract expiration I am happy with current agent but would like more alternatives 1. Please describe the home you would like to sell.      Type of Home: Select One Single Family Home Townhome Condo Multiple Family Vacation Home Investment Property Other      Price Range: Select One $125,000 - $175,000 $175,000 - $225,000 $225,000 - $300,000 $300,000 - $400,000 $400,000 - $500,000 $500,000 - $600,000 $600,000 - $800,000 $800,000 - $1,000,000 $1,000,000 - $1,500,000 $1,500,000 - $2,000,000 $2,000,000 - $3,000,000 Under $125,000 Over $3,000,000      Square Footage: Select One Under 1,000 1,000 - 1,250 1,250 - 1,500 1,500 - 1,750 1,750 - 2,000 2,000 - 2,500 2,500 - 3,000 3,000 - 3,500 3,500 - 4,000 4,000 - 4,500 4,500 - 5,000 Over 5,000      Bedrooms: Select One 1 2 3 4 5 6 or more      Bathrooms: Select One 1 2 3 4 5 or more      Size of Lot: Select One Less than 1/4 Acre 1 to 3 Acres 1/4 to 1/2 Acre Over 3 Acres 1/2 to 1 Acre Don't Know 2. Why are you selling your home? Want larger home Want smaller home Want better neighborhood / location Job relocation Retirement Divorce / separation Selling vacation home Selling rental home Financial reasons Other 3. Please describe the home you would like to purchase.      Type of Home: Select One Single Family Home Townhome Condo Multiple Family Vacation Home Investment Property Other      Price Range: Select One $125,000 - $175,000 $175,000 - $225,000 $225,000 - $300,000 $300,000 - $400,000 $400,000 - $500,000 $500,000 - $600,000 $600,000 - $800,000 $800,000 - $1,000,000 $1,000,000 - $1,500,000 $1,500,000 - $2,000,000 $2,000,000 - $3,000,000 Under $125,000 Over $3,000,000      Square Footage: Select One Under 1,000 1,000 - 1,250 1,250 - 1,500 1,500 - 1,750 1,750 - 2,000 2,000 - 2,500 2,500 - 3,000 3,000 - 3,500 3,500 - 4,000 4,000 - 4,500 4,500 - 5,000 Over 5,000      Bedrooms: Select One 1 2 3 4 5 6 or more      Bathrooms: Select One 1 2 3 4 5 or more * 4. Please describe your credit history. Select One Excellent Good Fair Poor 5. What features of your new home location are most important to you? (Select all that apply) Affordable Low Crime Good School System Short Commute Weather / Climate Walk to Restaurants / Shops Walk to Park(s) Other * 6. Where would you like to live? Please enter at least one ZIP Code .         * First Name * Last Name * E-mail Address *  Address of Home to be Sold * City * ZIP Code * Daytime Phone Ext  Cellular Phone Evening Phone * Preferred Contact Time Select One Any Phone - Anytime Cell Phone - Anytime Morning Mid-day Evening Weekend

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