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Jimmy Adams, Broker / Agent
Email: jimmy@adamsrealtykosciusko.com
Phone: 662-289-6131

Paxton Pettit, Broker, Sales Associate
Phone: 662-289-6131

Dwain Atwood, Broker, Sales Associate
Phone: 662-289-3325

Caye Adams, Sales Associate
Phone: 662-289-6131
Home: 662-289-7291

Mike Horn, Sales Associate
Phone: 662-289-6131
Cell: 662-582-1396

Lori Kyle, Sales Associate
Phone: 662-289-6131
Cell: 601-953-9465



Fax: 662-289-1005

Information Request


Community Information



Contact Us

If you will take the time to provide us with the information below, it will help us to match your needs with the available properties in our area and allow us to serve you better and without delay. We have designed this form to assist you in obtaining the most out of the current Real Estate market.

GENERAL INFORMATION
Name:
Address:
City:
State:
Zip Code:
Fax:
Telephone:
Best Times to Call:
E-Mail Address:


Are you interested in receiving a relocation package from us? Yes No

HOME PREFERENCES
Do you currently own a home?     If yes, what is the status of your current home?
YesNo    
I am looking for property to be used as...     What style home do you prefer?
   
How many bedrooms do you prefer?     How many bathrooms do you prefer?
   
Do you prefer a home with a garage?     If yes, what size garage do you prefer?
YesNo    


WHICH OF THE FOLLOWING LOCATIONS ARE IMPORTANT TO YOU?

Near School YesNo   Near Downtown Business District YesNo
Outside City Area YesNo   Near Medical Facilities YesNo
Other Location Preferences:  


WHICH OF THE FOLLOWING FEATURES ARE IMPORTANT TO YOU?
House with Basement YesNo   Office Space in Home YesNo
Sunken Living Room YesNo   Formal Dining Room YesNo
Property With Acreage YesNo   Workshop Space YesNo
Other Features Preferred:  
If you prefer property with acreage, how many acres do you prefer?  


PERSONAL INFORMATION (OPTIONAL)

Marital Status
Number of children living with you
Is there anyone living with you that is physically challenged and requires special features within the living space? YesNo
If yes, please explain:
How do you plan to pay for your purchase?
What percentage of mortgage would you be looking to secure?
If you are anticipating securing a mortgage, please provide your estimated annual income.