Buyer Information Form

*First Name:
*Last Name:
Address 1:
Address 2:
City:
* State:	Choose State Alabama Alaska Arizona Arkansas California Colorado Connecticut D.C. Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
* Zip Code:
*Phone:	( format: 555-555-5555)
*Email:
Best time to call:	Select one Morning Afternoon Evening
How many bedrooms?:	Select one 1 2 3 4 5 or more
How many bathrooms?:	Select one 1 1.5 2 2.5 or more
Want a garage?:	Select one Yes No Does not matter
Desired square footage:
How is your credit?:	Select one Excellent Good Fair Poor Bad Yikes! None
Maximum monthly payment desired:
Area/Location of interest:
Maximum price desired:
Maximum downpayment desired:
How about a Fixer-Upper?	Select one Yes No Maybe
Comments/Questions: