I Want To
Buy A Home

Your Name: Your Phone Number: including area code If you can receive information by fax what is the fax number including area code? Address: City: State: ZIP: E-mail: Do you have a school district preference: Columbia East Dan Emmett Pleasant Twin Oak Wiggins Any Mount Vernon School Fredericktown East Knox Danville Centerburg Northridge Northfork Any School District Do you own your home or are you renting? Own My Home Renting How many family members will be living in this home? How soon would you like to get in your new home? Within 1 week 2 Weeks or less Within 1 month 1-2 Months 2-6 Months Within the next year Not sure when What style home do you like? Ranch (1 Story) Cape Cod (1 1/2 Story) 2 Story Bi Level Raised Ranch Split Level Earth Home Condo Duplex Mobile Home Double Wide Modular or Manufactured Any Style Home-I'm Open Minded Other What is the minimum number of bedrooms that you need? 1 Bedroom 2 Bedrooms 3 Bedrooms 4 Bedrooms 5 or more bedrooms How many baths? Whatever we can get in our price range 1 Bath Minimum 1 1/2 Baths 2 Baths 2 1/2 Baths 3 Baths Do you need a garage? 1 Car 1 1/2 Car 2 Car 2 1/2 Car 3 Car 3 1/2 Car 4 Car or Larger Pole Barn/Garage Attached Garage Detached Garage Combination Other None Tell me about any special features that are important to you: What price home are you considering? Have you been preapproved for a home loan yet? Yes No Do you have a specific bank or mortgage company that you would like to work with? Did you know that I can get todays interest rate locked in for approximately 30 days to protect you against future rate increases? Yes No Would you like for us to lock the rate in for you? Yes No When is the best time for you to view homes? Please select one of these options: or Thank you for taking the time to complete this questionnaire. We will be in touch with you. Sam Miller RE/MAX Stars Realty

710 South Main Street, Mount Vernon, Ohio (740) 397-7800

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