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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?
               State:    ZIP: 

           Do you have a school district preference:
           Do you own your home or are you renting?
         How many family members will be living in this home?

          How soon would you like to get in your new home?

            What style home do you like?

          What is the minimum number of bedrooms that you need?

                     How many baths?

                    Do you need a garage?

     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?

       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?

      Would you like for us to lock the rate in for you?

        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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