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Information Request Form In order to serve you best, I need information about you and your home requirements. Please complete the form below and click Submit to e-mail to me. Normally you will receive a response in less than 24 hours. Name Address City State Zip Code E-Mail Address Daytime Phone Number with area code Evening Phone Number with area code Fax Number with area code The best way to contact you is Phone Fax U.S. Mail E-Mail Yes, send me information on homes in the Indianapolis Area! Price Range under $150,000 $150,000-$250,000 $250,000-$350,000 $350,000 and up Areas Desired Indianapolis Avon Brownsburg Carmel Fishers Geist Greenwood Noblesville Plainfield Westfield Zionsville , Indianapolis Avon Brownsburg Carmel Fishers Geist Greenwood Noblesville Plainfield Westfield Zionsville , Indianapolis Avon Brownsburg Carmel Fishers Geist Greenwood Noblesville Plainfield Westfield Zionsville , other Type of Home Two-Story Single-Story Condo , other Bedrooms two three four five + five Age of Home No Preference New Newer Resale Older Home How soon are you looking to buy? Immediate 0-90 days next 6 months next year Are you currently working with another REALTOR? No Yes Do you have a home to sell? Yes No Would you like a comparative market analysis of your current home, giving you the approximate market value of your home? Yes No Would you like information on financing? Yes No Other comments or special features you desire in a home: By submitting this form with a phone number you are hereby granting F. C. Tucker Company and agent permission to contact you at the telephone number(s) listed until F. C. Tucker Company, Inc. and agent are given written notice to stop. Copyright Dale Billman 2003