1. Do you currently own or rent your home.           Own         Rent

2. When do you plan on purchasing your next home.
0 to 3 months         3 to 6 months         Uncertain

3. What is the reason for you move?
Business         Retirement         Other

4. Number of bedrooms desired?          

Price Range
  Less then $100,000 $175,000 - $200,000
  $100,000 - $125,000 $200,000 - $225,000
  $125,000 - $150,000 Greater Then $225,000
  $150,000 - $175,000
All fields marked with a * are required.
Name: *
Address:
City: *
State: *
Zip Code:
Phone: (home)
Phone: (work)
E-Mail: *
Additional Information:

   

 
 

ReMax Southland Realty
Randy White
620 NC Hwy. 42 W.
Clayton, NC 27520
(919) 422-1530

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