Property Owner Wants to List Questionnaire

Fields marked with an asterisk* are required.

Your Property for Sale: Please contact me in regard to the SALE of my property located at:
*Street, RFD or Hwy:

*Town, State, Zip code:

Selling Interest:
Property Type:

Description:

Bedrooms:

Baths:

Style:

Approx. Value is $

Your Contact Information:

I AM THE OWNER OF RECORD: Yes No

My property is listed with another broker: Yes No

I CAN HELP FINANCE A BUYER FOR MY PROPERTY Yes No

*First Name:

Initial:

*Last Name:

*Street Address:
*City:	*State:	*Zip:

Thank you for providing the necessary information

Equal Housing Opportunity

Shore & Country Real Estate
Mailing: P.O. Box 69 • South Lyme, CT 06376
Office: 249 Shore Rd • Old Lyme, CT

www.CTBeach.com
email: salty@CTBeach.com
1.800.292.1695

1.888.CTBEACH
888.282.3224 • 860.434.1695
fax: 860-434-0076