Electronic Home Appraisal Form Please Complete The Following and Click on the Submit Form Button. Or, Complete the Form, Print it out and Fax to Lou Piccioni at 416-207-0278. Contact Information: Name: City: Telephone: Ext: The best time to call me is: Select A Time Morning Afternoon Evening Home Description & Features: Detached Semi-Detached Bungalow Town Home Condo Bungalow 11/2-storey 2 storey 21/2-storey Sidesplit Backsplit Square Footage: Lot Size: Location: Bedrooms: Select One Two Three Four Five or More Bathrooms: Select One Two Three Four Five or More Study/Den: Yes No Family Room: Yes No Pool: Yes No Fireplace: Yes No Basement: No Full Rec. Rm. Apartment Short Crawl Walkout Sauna: Yes No Main Floor Laundry: Yes No Garage: No Single 1.5 Car 2 Car 3 Car Central Air: Yes No Central Vac: Yes No Heat: FA Gas FA Oil FA Elec. Elec. Basebrd. Hotwater Oil Hotwater Gas Other Please list other features: Financial Expectations: What Selling Price Are You Considering? Have You Conducted a Recent Market Evaluation of Your Home? No Yes Lou will contact you within two business days of receiving this form. * Not intended to solicit properties already listed.

Lou Piccioni, Sales Representative Royal Lepage West Realty Group Ltd. 5110 Dundas Street West | Toronto, Ontario | M9A 1C2 Telephone - (416) 233-6276 Fax - (416) 233-8923 | E-Mail - lou@realestateetobicoke.com