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	Seller's Request for Market Analyis

To help us supply you with the best possible Complimentary Market Analysis, it would help us to help you better if you would kindly take a few minutes to select your options from this form. If you prefer not to, then just send us an email.

Your information is confidential. We do not sell it or pass it on to advertising firms. Nor do we use it to contact other people at your place of work, understanding that your plans to sell your home may not be public knowledge.

Personal Information:
(* = required field)
   First Name *
   Last Name *

   Spouse First Name
   Spouse Last Name

Address of house being sold.
   House Number *
   Street *
   City *
   State/Province *
   Zip Code *
   Country *
   Do you own this home? *

Your Contact Information
Check this box if your mailing address is the same.

Mailing Address (fill in if different from above).
   Street Number
   Street Name
   Apt #/Suite #/P.O. Box #
   City
   State/Province
   Zip Code
   Country

   Email *
   Phone Number *
   Business Phone Number *
   Fax
(* One phone number required)

Information about House to be sold:
   How many bedrooms are there?
   How many bathrooms are there?
   How many square feet?

   What style is the home?
   Approximate age of the house?
   How long have you lived there?
   When do you plan to list the house?
   Do you need to purchase another home?*

Fill in this section if it applies. Otherwise proceed to the "Comments" section or click on the "Submit" button below.

If you are moving.....
What state & city are you moving to?

Note:If the city name is not listed above choose "other" and type name in space below.
   Other City (if applicable)
   Suburb or Township (if applicable)

Do you need relocation materials about this city?

Describe the house you want to buy.
   Minimum Price
   Maximum Price
   How many bedrooms are needed?
   How many bathrooms are needed?
   How many square feet?
   What style home would you prefer?

Comments:
Any extra comments, or specific items you wish to address. The more you tell us about the home to be sold and your relocation needs, the better we can asist you!