Property Address  OR WA

                                            Street                      City            State            Zip                  Unit#

TCG       MLS#    No MLS#

Building Square Foot     Lot Size       Vacant     Occupied

Special Instructions

Agent Name          Cell Phone

Office     Branch     Office Phone

Sponsor

Assistant/Coordinator     Phone

Property Owner has signed an authorization waiver in you listing packet   Yes     No

Tour Packages:                                                            Add On:

HD Virtual Tour w/ Stills $200                               Keepsake CD

Standard Tour w/ Stills $99                                     Additional Keep sake CD's      Quantity

Standard Virtual Tour $80                                      Extra 360 Shots    Quantity      

Stills Only $80                             

E-mail address:

(Please have your e-mail open, or print the screen and fax this form to ensure a successful transaction)