|
| First Name: |
|
| Last Name: |
|
| Property Address |
|
| Address 2: |
|
| City: |
|
| Zip Code: |
(5 digits) |
| Email: |
|
Contact Phone:
(To clarify your information - We will call you ONLY if clarification is needed) |
|
| Preferred Contact Method: |
|
| Number of Bedrooms: |
|
| Number of Bathrooms: |
|
| Approximate Square Feet (If known): |
|
| Parking: Garage, carport, number of spaces.: |
|
| Does your home have a swimming pool? Spa?: |
|
| Rate your home's general overall condition from 1 - 10 (10 being best) |
|
| Tell me more. What makes your home unique? Any special features? Anything else???: |
|
| How Soon do You Anticipate Putting Your Property on the Market? |
|
|
|
| If you are working with a Bregman Properties agent please enter that agent's name here. (Otherwise, please enter "no agent"): |
|
|
|
|
|
|
|
