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Name [required] Address [required] Home Phone [required] Work Phone Cell Phone Fax Email Address [required] Your Website How did you hear about us? -- select option -- friend co-worker family member web search sign/advertisement calling card TV ad When are you planning to sell your home? -- select option -- immediately less than 3 months less than 6 months this year next year not sure Where will you be relocating to? -- select option -- Locally In Florida Out of state Undecided I own a -- select option -- single family home condominium townhome building lot It is located in -- select option -- Destin Fort Walton Mary Esther Navarre Crestview Okaloosa Island Niceville Bluewater Bay South Walton Beaches of South Walton Price Range -- select option -- $50,000 - $100,000 $100,000 - $150,000 $150,000 - $200,000 $200,000 - $250,000 $250,000 - $300,000 $300,000 - $350,000 $350,000 - $400,000 $400,000 - $500,000 $500000 + Number of Bedrooms -- select option -- 1 2 3 4 or more Number of Bathrooms -- select option -- 1 1.5 2 2.5 3 or more Garage -- select option -- 1 car 2 cars 3 cars + carport no garage Levels -- select option -- 1 story 2 story 3 story Current Use -- select option -- permanent residence vacation home investment Waterfront: Yes No Waterview: Yes No Waterfront -- select option -- gulf bay harbor bayou intercoastal none Waterview -- select option -- gulf bay harbor bayou intercoastal none Pool: Yes No Fireplace: Yes No Golf Course Lot: Yes No Beach Access: Yes No Any other comments about your house or neighborhood?

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