DATE:

SALES AGENT:

NAME

SPOUSE/PARTNER:

ADDRESS

PHONE (H)

PHONE (W)

PHONE (C)

CHECK TYPE OF PROPERTY SEEKING:

HOME

OR

INVESTMENT 

OCCUPATION

ANNUAL SALARY

OCCUPATION (WIFE/PARTNER)

ANNUAL SALARY

DAYS OFF FROM WORK

DAYS OFF WIFE/PARTNER

HOW SOON ARE YOU LOOKING TO PURCHASE PROPERTY?

DO YOU GIVE OUR OFFICE THE RIGHT TO RUN YOUR CREDIT?

-SELECT- YES NO

(IF YES, PLEASE WRITE YOUR SOCIAL SECURITY NUMBER HERE)

HAVE YOU BEEN PRE-APPROVED FOR A MORTGAGE?

-SELECT- YES NO

IF YES, FOR HOW MUCH?

(PLEASE PROVIDE OUR OFFICE WITH THE PRE-APPROVAL LETTER IF ANY)

ARE YOU CURRENTLY WORKING WITH ANOTHER BROKER?

-SELECT- YES NO

DO YOU HEREBY GIVE BABEL REALTY THE EXCLUSIVE RIGHT TO LOCATE A PROPERTY FOR YOU, THEREFORE AGREEING TO WORK WITH OUR OFFICE ONLY AND NO OTHER BROKERS FOR A PERIOD OF 60 DAYS?

-SELECT- YES NO

IF YES, PLEASE DIGITALLY SIGN HERE: