Buyer Contact Information

Please fill out the form below.
* Indicates required fields.

Buyer 1:

*First Name:

*Last Name:

*Email:

*Phone:

Buyer 2:

First Name:

Last Name:

Email:

Phone:

*Address:

*City:

*State/Province:

*Zip:

Country:

Children:

Child Name:

Age:

Child Name:

Age:

Child Name:

Age:

*Would you like to work with a particular agent in our office?
If so, who?

*School district desired?

Price cap:

*Sq Ft:

*Beds:

*Baths:

Number of Stories:

*Lot size:

Any special issues or requirements?

Why are you moving?

When do you want/have to move?

What is the most important thing to you in this process?

Do you have any concerns about making a move?

Who else are you talking to about buying a house?

What is most important about the real estate agent and company you choose?

Are you selling your current home?

YesNo

If Yes, what is the address?

Address:

City:

State/Province:

Zip:

Country:

Texas Real Estate Commission Information About Brokerage Services
Texas Real Estate Commission Consumer Protection Notice

Longview Office: 903-212-2896 separator

Kilgore Office: 903-984-6183