Name

Phone Number

Email

Rental Address

I would consider my home to be in: I would consider my home to be in:Excellent ConditionGood ConditionFair ConditionPoor Condition

When will the property be move-in ready?

Is the property currently occupied? Is the property currently occupied? Owner occupied Tenant occupied Currently vacant

Do you need to lease this home in order to buy another home: Do you need to lease this home in order to buy another home: Yes No

Do you or will you live within 60 miles of the home: Do you or will you live within 60 miles of the home: Yes No

Were you referred by an agent? If so, please let us know who so we can thank him/her.

My goals/intentions for this property are (i.e.: serve as investment property, keep as rental until an ideal time to sell, move to property in the future, etc…)