Hal Gill, Realtor® Franklin Realty Consultants, 2965 E Gulf to Lake Hwy, Inverness, FL 34453 PHONE: 352.212.2056 | FAX:   352.637.0783 Name: * Address or Area: Daytime Phone: * Evening Phone: * E-mail: * E-mail Confirm: * When do you plan to relocate? Please Select One ----> Less than 30 days 1-3 months 3-6 months 6 months to 1 year How long have you been in the market? Please Select One ----> Just starting Less than 30 days 1-3 months 3-6 months More than 6 months Have you met with a mortgage officer? Yes    No Type of property you are interested in: Single-Family Town Home Multi-Family Vacant Land Country Club Waterfront Golf Course Comments/Questions:

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