Full Name:

Home:

Work (Mr):

Work (Mrs):

Cell (Mr):

Cell (Mrs):

Fax:

Email:

Postal Address:

Physical Address:

Whose name is the property registered in?

Are you living in the property or is it rented out?

How long have you owned the property?

What type of home is it?

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

Garden

Established Needs work

Water features

yes no

Security

Electric fencing
Auto gates
Intercom system
Closed circuit TV
House alarm

Tennis court

yes no

Sauna

yes no

Jacuzzi

yes no

Flatlet

yes no

Describe

Underfloor heating

yes no

Air conditioning

yes no

What is the approximate size of the house?

m/2

Have you recently done any renovations or made any improvements?

yes no

Have you had a valuation over the past five years?

yes no

If so, were you satisfied with the valuation?

What would you consider the value of your home to be?

Would you like us to contact you to give a free market evaluation?

yes no

Would you like us to contact you to advise on the selling process?

yes no

Are you thinking seriously about selling?

yes no

If so, when?

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