Rox (602) 550-9981   
Buyers Request Form
Please fill-out the following Buyers Request Form. Based on the input we receive from this form, a list of matching homes can be prepared for you in a timely fashion. Your response is appreciated and will greatly help in your upcoming move.
Input Your Information
* Name
* Email
Phone
Address
City
State
Zip
Where are you moving?
City (2)
State (2)
Zip (2)
When do you anticipate purchasing your new home?
Information About The Home You Are Looking For
Type of Home
Approximately priced between
Number of Bedrooms
Number of Bathrooms
Interior Features and Preferences
Living Room
Family Room
Fireplace
Hardwood Floors
Den / Study
Laundry Room
Other Important Interior Features
Exterior Features and Preferences
Swimming pool
Spa
Waterfront
Garage
Tile roof
Fenced
Other Important Exterior Features
Additional Information
Have you ever been pre-approved or pre-qualified for a mortgage?
Do you have a down payment?
Have you had a credit report done lately?
Please use this space for any other comments or questions you might have.

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HomeSmart
1745 S Alma School Rd. Suite 115 • Mesa, AZ 85210
Rox (602) 550-9981 •



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