RELOCATION FORM
(Please answer all questions)
(
use <tab> to move to next field - <Enter> will submit form
)
Where are you planning on moving to?
To City:
To State:
Select A State
Virginia
Washington, D.C.
West Virginia
As part of this relocation do you need to sell your present home?
Yes
No
Your Information
First Name:
Last Name:
Present Address:
City:
State:
Zip:
Home Phone:
Fax:
E-mail:
Property Details
Property Style:
Please select as many options as needed
Residential-Single Family
Residential-Multi Family
Condo/Townhouse
Farm
Commercial (all types)
Vacation/Resort
Land (all types)
Bedrooms:
Any
1
2
3
4
5
Baths:
Any
1
1.5
2
2.5
3
3.5
4
Features:
Price Range:
$
to $
Timeline for Move:
MIMS,
ALL RIGHTS RESERVED
Revised: 06/27/04.