Main personal information

Fields marked with one * are obligatory

Title* :

Mr

Mrs

Miss

Surname* :

Name :

Address* :

Country :

Postal code * :

City* :

Daytime phone number* :

Evening phone number :

Mobile :

E-Mail* :

Fax :

Purchase information

Price from :

to :

Purchase reason

Purchase intention

Property type

Work to be carried out

	holiday home
	permanent move
	investment

	next 3 months
	within a year
	more than a year

	any
	land
	barn
	apartment
	town house
	village house
	country property
	business property

	to renovate
	habitable with work
	no major work
	new

Situation

Bedrooms

Other

	in town
	outskirts of town
	in a village
	outskirts of village
	hamlet
	rural area

	none
	1
	2
	3
	4
	5+

	cellar (wine)
	garage
	garden
	pool
	near water
	extension possible
	stables

Further information :

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