Relocation Request

Personal Information
First Name, Last Name   
Address
City, State Zip Code
Day Telephone
Evening Telephone
Fax
E-mail address (Required)
Are you a first time buyer? Yes   No
Do you need to sell your existing home? Yes   No
Information About Your Move
Where are you moving to? (city, state, zip code)
When do you anticipate purchasing your new home?
Information about home you are interested in
Type of Home Single Family Condo/Townhouse Farm
Multi-family Mobile Home Land Only
Priced between and
Number of Bedrooms 1   2   3   4   5   6+
Number of Bathrooms 1   2   3   4+
Interior Preferences
Living Room Yes   No
Family Room Yes   No
Fire Place Yes   No
Hardwood Floors Yes   No
Den/Study Yes   No
Laundry Room Yes   No
Other(include any other features)
Exterior Preferences
Swimming Pool Yes   No
Spa Yes   No
Waterfront Yes   No
Tile Roof Yes   No
Garage Yes   No
Fenced Yes   No
Other(include any other features)


Jim Maloof Realtor, Peoria, IL
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