Ken Haltiner Real Estate

Request for Relocation Information

Personal Information:

Your Full Name

Street Address

City

State

Phone Number

Zip

E-mail address

General information About Your Move:

Are you relocating?

Where are you moving

Yes

No

City

When do you anticipate purchasing your new home?

State

Zip

Information About The Home Your Are Looking For:

  Single family

  Condo/Townhouse

  Mulit-family

  Moble home

  Farm

  Land only

Number of Bedrooms

1

2

3

4

Number of Bathrooms

1

2

3

4+

Approximately priced between:

5

6

6+

and

Interior Features & Preferences

Living room

Fireplace

Den/Study

Family room

Hardwood floors

Laundary room

Other Important Interior Features:

Exterior Features & Preferences

Ocean view

Beach front

Tile roof

Spa

Garage

Fenced

Other Important Exterior Features:

Additional Information

Have you ever been pre-approved or pre-qualified for a mortgage?

If yes how much?

Do you have a down payment?

Yes

If yes, what is your maximum comitment?

Have you had a credit report done lately?

If Yes, any problems?

Yes

No

Yes

No

No

Yes

No

Please use this space for any other comments or questions you might have.

Ken Haltiner Real Estate  2016 3rd St. Tillamook, Or 97141
503.842.4428    1 800.842.4428  fax: 503.842.4412
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