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RELOCATING?
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Name:
Address:
City:
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Zip:
Home Phone:
Work Phone:
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Where Will You Be Relocating To?
Do you Rent or Own?
Rent
Own
Is your property listed?
Yes
No
If not, would you like a free, no-obligation market evaluation done on your home?
Yes
No
Do you need to sell before you buy?
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No
Do you need to be pre-qualified for a mortgage loan?
Yes
No
If yes, would you like our loan officer to contact you with information?
Yes
No
What is your preferred location?
What type of dwelling are you interested in?
Condo/Town Home
Single Family Home
Rental Apartment
Rental Home
Single Family w/acreage
Other
Price Range
What distance would you like from your place of employment?
within 10 miles
10-30 miles
Special Features Desired?
Active Military Duty
Rank/Grade
Time in Service
Estimated Move Date
Do you have need for childcare information?
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No
Additional Comments
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