Name

Address

Phone Number

E-mail Address

How would you prefer to be contacted?

When is the best time of day to contact you?

I'm interested in:

Buying Selling

Type of property:

Home Townhome Condo Lot / Acreage Farm or Ranch Commercial Property

Price Range:

Lake preference:

Waterfront Water Access Off-Water Golf Course Other

Size (Square footage or acreage):

Number of Bedrooms:

Number of Bathrooms:

Other preferences:

When do you plan to buy / sell:

Immediately Within 6 months Undecided Within 2 months Within a year

	How did you find out about Simpson Realty, REALTORS?

Newspaper ad     Real Estate Booklet     Search Engine

Personal referral   For Sale Sign

Other

	Comments / Questions