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FL licenses #CQ-1005987, #BO-2004290 and #BK-0533718
I certify that I am 18 years of age or older. (Required)
Yes, I want a FREE Buyer's Agent to help me find a property. I plan to buy within 6 months.
Yes, I want a FREE Property Evaluation. I plan to sell within 6 months.
I am working with one or more other Florida Realtors: (Required) Yes No
I am interested in: (Required)

I plan to look at properties around the month of: (Required if Buying)

I plan to purchase a property around the month of: (Required if Buying)

Salutation: (Required)

First Name: (Required)

Last Name: (Required)

Spouse or 2nd Party:

Street Number and Name:

City: (Required)

State/Province: (Required)

Zip/Postal Code: (Required)

Country: (Required)

Email Address: (Required)

Confirm Email Address: (Required)
(Must be exact even as to upper and lower case)

Area Code and Phone:

Area Code and Home Phone:

Area Code and Fax:

Best time to call me:

Best to call me at:
My Home Phone My Business Phone
I found your web site via:

Name of newspaper, magazine, other search engine, directory,
or web address where I found the link to AmStar's site:

Name of Friend Or Relative Who Referred Me To You:

Property I am thinking about selling:
(Select 1 or More - hold down "Ctrl" key to select more than 1)

I must sell my present property before buying:
Yes No
I am thinking about putting my property on the market within:

I intend to sell my property myself, without a Realtor (by owner).
My property is already listed with a Realtor.
Address of property I am going to sell is same as mailing address above.

Address I will be selling is different than mailing address:

Price range of property I may be selling:

Description of property I may be selling:

Property I'm thinking about buying:
(Select 1 or More - hold down "Ctrl" key to select more than 1)

The residence I am seeking should be:

I would be buying within months.
I have been pre-qualified for a loan:
Yes No
Have a loan officer contact me for FREE pre-qualification:
Yes No
I am thinking about buying in City of:
(Name of city, cities or county\s. Not sure? The map link above may help.)

Price range of dwelling I may buy:

Price range of business or investment property I may buy:

Reason I would be moving:

My employer is:

Detailed Description is helpful.
Further Description of property I am seeking:

I Prefer Year Built:

Sq. Ft. Living Area:

Style (Select 1 or More):

If a Condo - What Floor?:

If Condo - Water View?:

If Condo - Maximum Monthly Maintenance Fee?:

If Condo - Balcony?

Want it in a Retirement Development?




Half Baths:


Florida Room (Sunroom):



Prefer Waterfront?:

Waterfront Type (Select 1 or More):

Waterfront Extras:

Front Exposure (Select 1 or More):

Additional Description of Property I Am Seeking:

I would like you to (describe service you expect):

I have the following SPECIAL REQUEST:

Comments and/or Property ID Numbers:

Prefer a certain agent? Enter agent's name here:

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have read and do agree with the

Privacy Policy.

AmStar Realty Group, Inc.

Telephone (Country code 001) 727.304.6095

AmStar Realty Group works as buyer's broker, seller's broker, transaction broker, non-representation broker or referring broker depending on the situation.

This form last modified November 26, 2016, priv. pol. 02/05/04 - offer 01/20/04 - priv. link here 02/13/04 )

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This page last updated Saturday, November 26, 2016 7:28 PM Florida Time, USA.
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