REAL ESTATE CLIENT INTAKE FORM

DISCLAIMER: Thank you for your interest in being a client of [AGENCY/AGENT NAME]. Information collected about new clients is confidential and will be treated accordingly.

CLIENT INFORMATION

Client Name: _____________________ ☐ Buyer ☐ Seller
Client Street Address: ______________________________
City: _____________________ State: _____________________ Zip Code: ________
E-Mail: _____________________ Phone: _____________________

Property of Interest: __________________________ (MLS#_________)

If buying, are you pre-approved: ☐ Yes ☐ No

If yes, with whom? ___________________________________________

How did you hear about us? ______________________________________

Property type: ☐ Land/Lot/Acreage ☐ Residential ☐ Investment ☐ Commercial

Timeframe for buying/selling? ______________________________________

Property information: _____________________________________________

Additional information: _____________________________________________

SIGNATURE

Signature: _________________________ Date: ___________
Printed Name: ____________________