| Owner of property is: |
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| Company Name (leave blank if Owner): |
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| Name: |
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| Address of Owner or Broker: |
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| eMail Address: |
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| Property address: |
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| City, State, Zip: |
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| Phone: |
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| This property is for: |
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Property Description
 OWNERS and/or
AGENTS: Please complete the following. The more information we have the better we can
disclose it to potential CLIENTS |
| Type of Property: |
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| Property Address: |
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| City: |
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| State: |
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| Zip: |
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| Country: |
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| Price:(in USD)$ |
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| Brief description of property in this box: |
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| Special terms and financing available in this box: |
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| Please describe source of income, rents, leases, etc. Also include
answers to what a potential Client might ask in this box: |
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| If available for exchange, describe what type property Owner will take,
in this box: |
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| Property taxes, describe how they are computed: |
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Mandatory: Total 2001 and 2002 INCOME
(in Dollars):
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2001
2002 |
| Mandatory: Total 2001 and 2002 EXPENSES
(in Dollars): |
2001
2002 |
By completing, submitting, and placing OWNER’S or AGENT’S eMail address in box
provided below, Owner or Agent certifies that the figures contained herein are true and
accurate. Owner or Agent also acknowledges that by placing his/her eMail address below
constitutes Owner’s or Agent’s signature attesting to said accuracy.
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| I have read and accept the terms and conditions contained in the
Authorization to Place Ad Form and hereby acknowledge same: |
Signature = eMail address:
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