Cnetury 21 Chris W. Nelson  
  

Phone: (559) 555-5555•  FAX: (559) 555-5550 •111 Anydrive Ave • Anytown, CA 00000

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Let us tell you the value of your home

Contact Information:

Title

First Name

Last Name

E-mail

Tel

() -

FAX

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Property Information:
# of Bedrooms
# of Baths
Square footage
Year Built 
Location of Property:
Street address
City CA
Zip code
Please check each of the following features/amenities that apply:
Family RoomYes   No
DenYes   No
Formal DiningYes   No
Fire PlaceYes   No
PoolYes   No
Spa Yes   No
Guest HouseYes   No
  
Cooling 
  
Garage Capacity
  
Garage type 
  
Property type
  
When are you planning to sale?
  
Is your house currently listed?
  
Where are you planning to move?
  
How did you hear about us?



Any upgrades/remodeling which should be considered:

Additional features or comments:

 

 

 
 
 

 

  
  

 

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Last Updated on: Thursday, December 29, 2011 02:30:15 PM