Request Information

Don & Gloria Wallace
ERA Strother
2931 Breezewood #200
Fayetteville, NC 28301

Office: 910.864.2325
Cell: 910.818.9600
FAX: 910.323.1198

www.teamwallace.com


home4sale@earthlink.net

Simple requests for more information on VA properties and tax deferred 1031
exchanges may be made by simply e-mailing Team Wallace.

Clients with requests for relocation assistance should fill out the detailed form below.

Full name:
Spouse's name:
Street address:
State:
ZIP code:
Country:
Email address:
Telephone number:
Pager number:
FAX number:
Mobile or cellular phone number:
Number of children:
Occupation:
Spouse's occupation:
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:
If Other, please describe:
Style of home:
If Other, please describe:
Construction of home:
Bedrooms:
Bathrooms:
Total number of rooms:
Square footage:
Formal living room or dining room: Living Room      Dining Room      Neither  
Garage: Yes      No  
Special requirements:
Do you own now? Yes      No  
What type of loan are you considering?
What is your price range?
What is your expected down payment?
When do you arrive in the Fayetteville area?
When would you like to close on a home?
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?
Any questions or comments?