INFORMATION REQUEST FORM  1. (all required) First Name Last Name  2. Status: (required) Buyer, Lic. Real Estate Agent  3. Company Name (if any):  4. Street Address: (required) Apt.No:  5. (all required) City: State: Zip:  6. Country (if outside U.S.A.):  7. Home Phone (with area code):  8. Work Phone (with area code): (required)  9. Cell Phone (with area code): 10. E-mail address: (required) _________________________________________________________________  11. Type of purchase: (check all types considered):  Hotel-Motel, Marina, Shopping Center/Strip Plaza, Apartments,  Mobile Home Park, Office Building, Self-storage, Convenience Store,  Warehouse-Manufacturing, Commercial Land, Assisted Living Facility,  Gambling Related, Quick Turn Investments under 1-year, REO Packages,  Other Types - specify below .  12. Preferred Florida area:  13. Minimum rooms/units/spaces: , Maximum rooms/units:  14. Purchase Price Range: From: To:  15. Cash Available to purchase: (required) $ U.S. DOLLARS  16. Can you show proof of funds of Cash Available: (required) Yes, No  17. Financing: (required) Want seller financing, Have my own financing available  18. If seller financing is wanted, can you provide a personal financial statement  prepared by an accountant: Yes, No (required for seller financing)  19. More info on Property #: , , 20. Your Minimum Requirements for a Property: STOP - Verify that your email address is spelled correctly