39 Southend Road
Grays, Essex, RM17 5NH
T: 01375 393118
F: 01375 409825
E:
regentestates@aol.com
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Regent Estates - Purchaser Application Form
Purchaser Application Form
Contact Details
Forename:
Surname:
House Name / Number:
Street Name:
Town:
County:
Postcode:
Telephone Number:
Mobile Number:
Email:
Requirements
Bedrooms:
Select number of bedrooms
1
2
3
4
5
Other
If you selected 'other', please specify:
Property Type:
Select property type
Flat/Apartment
House
Bungalow
Other
If you selected 'other', please specify:
Freehold:
Select freehold type
Detached
Semi-Detached
End Terrace
Terrace
All
Location:
Select location
Grays/North Grays
Purfleet
East Tilbury
Tilbury
Stanford Le Hope
Corringham/Fobbing
South Ockendon
Other
If you selected 'other', please specify:
How soon do you need to move?
Special Requirements?
Present Situation:
Please tick all that apply:
First time buyer
Own to sell / on the market
Own to sell / Not on the market
Non-dependant
Renting
Cash Buyer
Sold subject to contract
What are you doing about your mortgage?
Have you spoken to a consultant?
Yes
No
Have you viewed properties recently?
Yes
No
Please enter the security code exactly as written in the image above for security verification:
Thank you for taking the time to complete the form, please click the send button and our lettings team will contact you as soon as possible.