| Full name: |
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| Spouse's name: |
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| Street address: |
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| State: |
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| ZIP code: |
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| Country: |
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| Email address: |
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| Telephone number: |
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| Pager number: |
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| FAX number: |
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| Mobile or cellular phone number: |
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| Number of children: |
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| Occupation: |
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| Spouse's occupation: |
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| Looking to rent, buy or sell? |
Rent
Buy
Sell |
| Do you currently own a home? |
Yes
No |
| Do you plan to sell your current home? |
Yes
No
Not Applicable |
| Home type you're looking for: |
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| If Other, please describe: |
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| Style of home: |
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| If Other, please describe: |
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| Construction of home: |
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| Bedrooms: |
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| Bathrooms: |
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| Total number of rooms: |
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| Square footage: |
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| Formal living room or dining room: |
Living Room
Dining Room
Neither |
| Garage: |
Yes
No |
| Special requirements: |
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| Do you own now? |
Yes
No |
| What type of loan are you considering? |
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| What is your price range? |
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| What is your expected down payment? |
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| When do you arrive in the Fayetteville
area? |
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| When would you like to close on a
home? |
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| Have you ever visited or lived in
Fayetteville? |
Lived
Visited
No |
| Do you need hotel or transportation
arrangements made? |
Hotel
Transportation
Neither |
| How did you hear about us? |
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| Any questions or comments? |
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