Use this form to be pre-qualified to BUY real estate through me and this site. Please take the time to fill out our short questionnaire as best as you can. Thank you. I look forward to serving your current and future real estate needs. 1 Personal Information Section Please provide all relevant personal contact information. Salutation* Mr Mrs Miss Surname* First Name* Address* City* Province* Postal code* Day phone* Night phone Office phone Fax Cellular E-mail* 2 Preferences Style Desired* Bungalow Raised Bungalow 1.5 Storey 2 Storey 2.5 Storey 3 Storey BackSplit FrontSplit Mulitilevel No preference Other Type Desired* Attached Detached Semi-Detached Link Cottage Farm Business Vacant Land Location* Oshawa Ajax Pickering Brooklin Port Perry Whitby Courtice Bowmanville Other Sq. Footage* 1000 or Less 1000-1500 1500-2000 2000-2500 2500-3000 3000 or More Best Time to call   me is* Morning Afternoon Evening Weekends only Any Time I am planning a  move for a * First time buyer Divorce / Seperation Smaller home Larger home Relocation Retirement Investment Recreation Immigration Price Range Under $100,000 $100,000-$150,000 $150,000-$200,000 $200,000-$250,000 $250,000-$300,000 Over $300,000 I prefer to be conntacted by Home phone Work phone Cell phone Email Any type Heat Forced air gas Forced air electric Forced air oil Electric baseboad Bedrooms One Two Three Four Five or more Bathrooms One Two Three Four Five or more Garage Yes No optional Central Air Yes No Optional Recreation room Yes No Optional Driveway Gravel Paved Interlocking optional Central Vac Yes No Optional 3 Submit Your Form Take a few moments to review your work, and correct any errors. Then choose a distinct and secure password. Username and Password are required if you choose to edit your form later. Username* Password*

Liz Rankin, Associate Broker RE/MAX First Realty Ltd. 223 Brock St. N., Unit 7 Whitby, Ontario L1N 4H6 Tel: 905-686-3800, Fax: 905-430-7840 E-mail: liz@realestatewhitby.com