First Name:

Last Name:

Phone:

Fax:

E-mail:

Street Address:

City:

Province:

Postal Code:

Number of Bedrooms:

1234567899+

Bathrooms:

1234567899+

Approx. Sq. Footage:

Under 700700 - 11001100 - 15001500 - 20002000 - 25002500 - 30003000 - 35003500 - 50005000+

Lot Size/ Acreage:

<.49.50 - 1.992 - 4.995 - 9.9910 - 24.9925 - 49.9950 - 99.99100+

House Style:

BungalowRaised BungalowOne and A Half StoreyTwo StoreyTwo and A Half StoreyThree StoreySplit Level 3 +Split Level 4 +Villa

Garage:

Single AttachedSingle DetachedDouble AttachedDouble DetachedTriple AttachedTriple DetachedCarportUndergroundNo Garage

House Type:

TownhouseCondominiumSemi DetachedDetachedLinkRow House

Parking:

Private DriveShared DriveLanewayCircular DriveOther

Overall Condition:

AveragePoorGoodExcellent

Basement:

Approximate Age of Home:

new1 to 5 years5 to 10 years10 to 20 years20 to 50 yearsover 50 years

When Do You Plan To Move?

immediatelyThree MonthsSix MonthsOne YearThree Yearsundecided

Additional Criteria and Information: