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e-mail address
street address
city, ...................................... state, ................................ and zip code
Phone number
Desired location of real estate to be purchased
Location of real estate to be sold (if any)
Approximate value of real estate to be purchased: Less than $100,000 $100,000-$200,000 $200,000-$300,000 Over $300,000
Please give a brief description of your real estate intentions and needs.