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United Realty, Your Residential Specialist

If you will take the time to provide us with the information below, it will help us to match your needs with the available properties in our area and allow us to serve you better and without delay. We have designed this form to assist you in obtaining the most out of the current Real Estate market.

GENERAL INFORMATION

Name:
Address:
City:
State:
Zip Code:
Fax:
Telephone:
Best Times to Call:
E-Mail Address:

Are you interested in receiving a relocation package from us? Yes No

HOME PREFERENCES

Do you currently own a home?			If yes, what is the status of your current home?
YesNo
I am looking for property to be used as...			What style home do you prefer?

How many bedrooms do you prefer?			How many bathrooms do you prefer?

Do you prefer a home with a garage?			If yes, what size garage do you prefer?
YesNo

WHICH OF THE FOLLOWING LOCATIONS ARE IMPORTANT TO YOU?

Near School	YesNo	Near Downtown Business District	YesNo
Outside City Area	YesNo	Near Medical Facilities	YesNo
Other Location Preferences:

WHICH OF THE FOLLOWING FEATURES ARE IMPORTANT TO YOU?

House with Basement	YesNo	Office Space in Home	YesNo
Sunken Living Room	YesNo	Formal Dining Room	YesNo
Property With Acreage	YesNo	Workshop Space	YesNo
Other Features Preferred:
If you prefer property with acreage, how many acres do you prefer?

PERSONAL INFORMATION (OPTIONAL)

Marital Status	Number of children living with you
Is there anyone living with you that is physically challenged and requires special features within the living space? YesNo
If yes, please explain:
How do you plan to pay for your purchase?
What percentage of mortgage would you be looking to secure?
If you are anticipating securing a mortgage, please provide your estimated annual income.

Certified
Residential
Specialist

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