OWNER NAME                       

PROPERTY ADDRESS         

CITY                                            Lake Worth Wellington Royal Palm Beach Loxahatchee West Palm Beach Lantana Palm Beach Gardens Boynton Beach The Acreage

ZIP                                             

BEDROOMS                             1 2 3 4 5 6 more than 6

BATHROOMS                           1 1.5 2 2.5 3 3.5 4 4.5 5 more than 5

SUBDIVISION                           

POOL?                                       YES - INGROUND SCREENED & HEATED YES INGROUND - SCREENED YES INGROUND -NO SCREEN YES- INGROUND - SCREENED, HEATED, with SPA SPA ONLY YES - ABOVE GROUND NO

WATERFRONT?                       LAKEFRONT LAKEVIEW ONLY CANAL POND OCEAN INTRACOASTAL NO

LOT SIZE                                   

DAYTIME PHONE                    

EVENING PHONE                   

E-MAIL                                       

RE-CONFIRM E-MAIL             

PREFER TO BE CONTACTED VIA PHONE - DAYTIME VIA PHONE - EVENING VIA E-MAIL

MORTGAGE BALANCE (If you'd like to have us prepare a closing costs estimate)  

ANY ADDITIONAL INFORMATION: