1903 Pass Road | Biloxi, MS 39531
Office (228) 388-6600
Fax (228) 388-7165
Toll Free 1-877-787-6600
Measuring Our Success By Your Satisfaction
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If you will take the time to provide us with the information below, it will help us to match your needs with the available properties in our area and allow us to serve you better and without delay. We have designed this form to assist you in obtaining the most out of the current Real Estate market.
GENERAL INFORMATION
Name:
Address:
City:
State:
Zip Code:
Fax:
Telephone:
Best Times to Call:
E-Mail Address:
Are you interested in receiving a relocation package from us?
Yes
No
HOME PREFERENCES
Do you currently own a home?
If yes, what is the status of your current home?
Yes
No
I Am Selling This Home
Home Is Sold, Awaiting Final Closing
I Am Thinking Of Selling
I Will Be Keeping My Current Home
Undecided and Looking for Advice
I am looking for property to be used as...
What style home do you prefer?
My Primary Residence
A Secondary Residence
A Residence For Family/Friend
Rental Property
A Vacation Home
A Speculative Venture
Ranch Style
2-Story Style
Bi Level (Split Level) Style
Colonial Style
Spanish Style
English Tudor Style
Vacation Home/Cottage
No Particular Preference
How many bedrooms do you prefer?
How many bathrooms do you prefer?
One Bedroom
Two Bedrooms
Three Bedrooms
Four Bedrooms
Five Bedrooms
More Than Five Bedrooms
One Bathroom
Two Bathrooms
More Than Two Bathrooms
Do you prefer a home with a garage?
If yes, what size garage do you prefer?
Yes
No
One Car Garage
Two Car Garage
More Than Two Cars
WHICH OF THE FOLLOWING LOCATIONS ARE IMPORTANT TO YOU?
Near School
Yes
No
Near Downtown Business District
Yes
No
Outside City Area
Yes
No
Near Medical Facilities
Yes
No
Other Location Preferences:
WHICH OF THE FOLLOWING FEATURES ARE IMPORTANT TO YOU?
House with Basement
Yes
No
Office Space in Home
Yes
No
Sunken Living Room
Yes
No
Formal Dining Room
Yes
No
Property With Acreage
Yes
No
Workshop Space
Yes
No
Other Features Preferred:
If you prefer property with acreage, how many acres do you prefer?
1-2 Acres
3-5 Acres
5-10 Acres
10-20 Acres
20-50 Acres
Over 50 Acres
PERSONAL INFORMATION (OPTIONAL)
Marital Status
Number of children living with you
Is there anyone living with you that is physically challenged and requires special features within the living space?
Yes
No
If yes, please explain:
How do you plan to pay for your purchase?
All Cash
Cash and Proceeds From Sale of Current Residence
Part Cash/Part Mortgage
Other Method of Payment
What percentage of mortgage would you be looking to secure?
Low Down Payment/High Mortgage
10% Down Payment/Mortgage for Balance
20% Down Payment/Mortgage for Balance
30% Down Payment/Mortgage for Balance
40% Down Payment/Mortgage for Balance
50% Down Payment/Mortgage for Balance
60% Down Payment/Mortgage for Balance
70% Down Payment/Mortgage for Balance
80% Down Payment/Mortgage for Balance
90% Down Payment/Mortgage for Balance
If you are anticipating securing a mortgage, please provide your estimated annual income.
$15,000-$20,000
$20,000-$30,000
$30,000-$40,000
$50,000-$60,000
$70,000-$80,000
$80,000-$90,000
$100,000-$125,000
$125,000-$150,000
$150,000-$175,000
$175,000-$200,000
$200,000-$250,000
$250,000-$300,000
$300,000-$400,000
$400,000-$500,000
$500,000-$700,000
$750,000-$1,000,000
More Than $1,000,000
ARLENE WALL REALTY, INC. · 1903 Pass Road · Biloxi, MS · 39531
Phone: 228-388-6600 · Fax: 228-388-7165