Coldwell Banker
Residential Real Estate
889 East Bloomingdale Ave.
Brandon, FL 33511
Office: (813) 662-1610
Toll Free: 888-298-2668

Please fill in the information below. For More Information Form


Personal Information
First Name Last Name
Address
City Zip State

Day Phone# Evening Phone# E-Mail Address

General Information About Your Move
Are you relocating?
Where are you moving too?
City: State: Zip:
When do you anticipate purchasing your new home?

Information About The Home You Are Looking For
Type of home:
Price Range:
Number of Bedrooms:
Number of Bathrooms:

Interior Features & Preferences
Living Room Family Room Fire Place Den/Study Hardwood Floors Laundry Room

Other Important Interior Features:

Exterior Features & Preferences
Swimming Pool Spa Waterfront Garage
Tile Roof Fenced

Other Important Exterior Features:

Additional Information
Have you ever been pre-approved or pre-qualified for a mortgage?

If yes, for how much?


Do you have a down payment?

If yes, what is your maximum commitment?


Have you had a credit report done lately?

If yes, any problems?

Please use this space for any other comments or questions you might have.