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 Price Range Are You Considering?

Have You Been Prequalified for a Mortgage? No Yes

Lou will contact you within two business days of receiving this form.

* Not intended to solicit properties already listed.