Excell Realty III, Inc.

Maderia Beach

Information Form

Please Fill in this Form as
COMPLETELY AS POSSIBLE.
We will contact you very soon.


Personal Information:
Last Name
First Name
Email Address (Required)
Street
City
State / Province
Country
Zip / Postal Code
Telephone (with Area Code / Regional Code) (Required)
Country Code (Telephone)

Purpose
Purchase
Holiday Rental
Longterm Rental
Annual Rental

Purchase Information
Approximate Purchase Date
Need to Sell Home to Buy
Ready to Purchase
Price Range
Check One
$50,000 to $100,000
$100,000 to $150,000
$150,000 to $200,000
$200,000 to $300,000
$300,000 to $400,000
$400,000 to $500,000
$500,000 or more

Rental Information
Arrive Depart
Weekly Rental
Monthly Rental
Price Range
Check One
$500 to $1,000
$1,000 to $1,500
$1,500 to $2,000
$2,000 to $3,000
$3,000 to $5,000
$5,000 or more

Preferences:
Preferred City or Area
Check All That Apply
Private Residence
Condominium
New Construction
Existing
Beachfront
Waterview
Golf Course View

Special Requests




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