Questionaire

Questionaire

Please enable us to assist you by completing the following form. A Prudential Relocation Consultant will be in contact with you promptly.

Relocation Questionnaire
(Items marked with ** in bold are required)

Last Name:

First Name(s):

E-Mail Address:

Current Address:

Street:

City:

State:

Zip Code:

Home:

Work:

Ownership Status:

Own

Rent

If you own:

Is Your Home Listed

Not Listed?

If yes, List Price?:

Employer:

New Hire Transfer

Children:

Number

Price Range:

Geographic Areas of Interest?

Number

Bedrooms Baths

Your Move To A New Area:

Does your employer provide Relocation Benefits?:

Yes

If yes, which relocation company?:

When do you expect to arrive there?:

Are you planning a preview trip?

Yes

If so, when?:

Mortgage Services

Have you been pre-qualified or pre-approved for a mortgage?:

Yes

Would you like to talk with a lender?

Yes

Other Needs or Wants

4111 Washington Ave.

Evansville IN 47714

812-474-7000