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Community of Interest:
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Primary Contact (First Name/Last Name):
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Secondary Contact (First Name/Last Name):
 
Address:   (required)
Second Address:  
City:   (required)
State:   (required)
Zip:   (required)
E-Mail:   (required)
Occupation:  
Home Phone:  
Work Phone:  
Cell Phone:  
Other Phone:  
Fax Number:  
     
How did you
hear about
Renar Homes:
  Drive By Friend T.V Website
Newspaper Radio Realtor
Other:  
Desired Price Range:   100,000 - 150,000 151,000 - 200,000 201,000 - 250,000 251,000 - 300,000 301,000 - 350,000 351,000 - 400,000 401,000 - 450,000 451,000 - 500,000 501,000 or More
Wish to
purchase by:
  Immediately 1 - 2 Months
3 - 6 Months 7 Months or More
Number of
Bedrooms desired:
 
We Now:   Own Home Rent None
Own Lot:   Yes No
     
Comments: