Full Name:

Home:

Work (Mr):

Work (Mrs):

Cell (Mr):

Cell (Mrs):

Fax:

Email:

Postal Address:

Physical Address:

Whose name is the property registered in?

Do YOU still need to sell or are you renting?

What type of home/property are you looking for?

Cluster Simplex Duplex Freehold Single story Double story Split levels Facebrick Plaster finish Contemporary Colonial Rustic Georgian Tuscan

Beds

1 2 3 4 5 6

Baths

1 2 3 4 5

Guest Toilet

yes no

Study

yes no

Lounge

yes no

Dining Room

yes no

Family Room

yes no

Kitchen

Wooden Melamine Granite

Scullery

yes no

Laundry

yes no

Maid's accommodation

yes no

Full bathroom

yes no

Shower & toilet

yes no

Outside toilet only

yes no

Garages

Single Double Triple Drive Through

Carports

Single Double Triple

Tennis court

yes no

Sauna

yes no

Jacuzzi

yes no

Flatlet

yes no

Describe

What is the approximate size of the house?

m/2

Are you thinking seriously about buying a home?

yes no

If so, when?

In the next year In the next two years In the next five years