Name E-mail Telephone Type of Home Detached Semi-Detached Condo Apartment Townhouse Freehold Townhouse Multi-Family Commercial Number of Storeys Flat Bungalow 2 Storeys 3 Storeys More Than 3 Storeys 3 Level Back/Side Split 4 Level Back/Side Split 5 Level Back/Side Split Number of Bedrooms 1 2 3 4 5+ Number of Bathrooms 1 1 + 1/2 2 2 + 1/2 3 3 + 1/2 4 4 + 1/2 5+ Square Footage How soon are you planning to sell? Immediately Within 3 Months Within 6 Months Within 12 Months More than 12 Monhs Are you currently working with a REALTOR? No Yes Address/Nearest Major Intersection City Comments