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Contact Information
First Name:
Last Name:
Address:
City:
State:
Postal/Zipcode:
Home (Evening) Phone:
Email Address:
Work (Day) Phone:
Cell:
Fax:
Questions for the Home Buyer
What is the most you can put down?:
What is the maximum monthly payment that you can afford?:
In which area (neighborhood, school district, etc.) are you looking to buy a home?:
What zipcode do you want to live in?:
How many bedrooms would you like?:
How many bathrooms would you like?:
Is a garage mandatory?:	Yes      No
Is your credit good, fair or ugly?:	Select Good Fair Ugly
Credit Score:
Are you ready to buy now?:	Yes      No
When do you want to move?:
Other requirements/Comments:
Other Questions
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Comments:
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