Your Email Address:

Owner/s Name:

Property Address:

City:

State:

Zip Code:

Home Phone:

Cell Phone:

How did you hear about Acuity Group?

Desired move-in date:

Is this an investment property? please select Yes No

Do you currently occupy this property? please select Yes No

If no, please list your full current mailing address:

What is your current monthly mortgage payment? $

Are you current on your monthly mortgage payment? please select Yes No

If no, are you in foreclosure or short sale negotiation proceedings? please select Yes No

Property type: please select Townhome/Duplex Condominium Single Family Home

Floor plan style: please select Rambler 2 Story Mod. 2 Story Split Entry 3 Level 4 Level Other

Association dues? please select Yes No

If yes, list monthly amount and frequency: $

Number of bedrooms:

Number of bathrooms:

Master Bath? please select Yes No

Year built:

Basement? please select Yes No

If yes, please describe:

Total sq ft finished:

Above ground finished square feet:

Below ground finished square feet:

Garage stall number/s:

Outbuildings or detached garages? please select Yes No

If yes, please describe:

Are pets allowed? please select Yes No

If yes, please describe specifications:

Are smokers allowed? please select Yes No

If yes, please list areas smoking is permitted:

Lot size:

Irrigation system? please select Yes No

Handicap accessible? please select Yes No

Additional comments/questions: