Response Form

In order for me to assist you further, please answer the following questions and enter your email address or phone number below.  Enter a comment or question about one of the homes available if desired.

How soon are you hoping to purchase a home?

Do you currently have a realtor?

Less than 6 months

Yes

Longer than 6 months

No

Have you been pre-qualified with a mortgage company?

How did you hear about me?

Yes

Word of mouth

No

Internet

Comments or questions:

Phone:

E-mail:

Richard Maassen, Jr. | Available Homes | Contact Richard

To contact us:

Phone: 555-555-5555
Fax: 555-555-5555
Email: xyz@microsoft.com