First Name:

Last Name:

Email:

Phone Number:

Fax:

Property Address: 

House Number   Street

City   State   Zip 

Property Type:

Single Family   Condo   Town home   Loft  

Commercial   Land   Multi Family   Condo Conversions

Four Or More Units    Co-Op

Other: (please specify below)

Property Details: 

Lot Size (If Applicable)   Sq. Feet Of Home

Year Built   # Of Bedrooms   

# Of Bathrooms 

Primary Rooms: (check all that apply)

Living Room   Dining Room   Dining Area   Florida Room  

Family Room   Great Room   Breakfast Room   Foyer

Eat In Kitchen    Game Room   Den   Laundry Room

Other: (please specify below)

Features Of The Property: (check all that apply)

Beachfront   Beach Area   Downtown

 On New River   Near Interstate   Waterfront

Suburban   Near Shopping   High Ceilings   Pool

On Golf Course   Guest House   Sauna

Spa   Fireplace   Private Tennis Court   Covered Parking

Guest Parking   Pets OK   Fenced Yard   Two Story

Other: (please specify below)

Appliances: (check all that apply)

Refrigerator   Range   Oven   Dishwasher   Dryer

Ice Maker   Disposer   Freezer   

Wine Cooler   Trash Compactor

Other: (please specify below)

Homeowner's Association (check all that apply)

Voluntary   Mandatory   Co-Op Association

Condo Association   Club Membership Required

Club Membership Optional   Approval Required   Gated

View:

Intra Coastal   New River   River   Bay   Canal

Park   Ocean   Lake   City   Pool

Golf Course   Garden

Waterfront Features: (check all that apply)

No Fixed Bridge   Fixed Bridge   No Ocean Access   

Oceanfront   On Canal   On River   On Intra coastal   

On Lake   Private Dock   Community Dock   

Deeded Dock   Utilities Dock   Boat Lift   No Wake Zone

Garage:

Attached One Car   Attached Two Car   Attached Three + Car

Detached One Car   Detached Two Car   

Detached Three + Car   Carport One Car   

Carport Two Car   Community Garage

Community Uncovered None

Air Conditioning & Heat: (check all that apply)

Central AC   Central Heat   Wall Unit(s)

Fireplace   None   Other   

Do You Have Any Additional Features Or Upgrades Which Should Be Considered? Describe Any Significant Improvements, Additions, Remodeling, Or Anything Else That May Help Me Determine Your Property's Value:

When do you plan to sell your property?

Now   Within 30 Days   Within 60 Days   Within 90 Days

When I Find A New Home   Undecided   Other

Why Are You Selling?:

Need A Larger Home   Relocating Out Of Town   

Need A Smaller Home   Estate Sale   Divorce   Other  

Do You Need To Find A New Home?:

Yes   No   Yes In Another City   

If You Are Moving Out Of Town Would You Like Me 

To Refer You To Top Agents In That Area?

Yes   No   

Would You Like To Subscribe To My Monthly Newsletter?

Yes   No   

How Did You Find My Website?

Web Surfing   Other Website   Personal Recommendation   

Miami Herald   Sun Sentinel   New York Times   Advocate

Other Magazine   Radio   Post Card Or Mailer   

Client Of Mine

Other (specify below)

Question, Suggestion, Comments: