Street + House no.:

Residence:

Bid on behalf of: Bid on behalf of: Myself, as a private person Myself and my partner, as a private person For a customer, as a purchasing broker

Viewed property: Viewed property: Yes No

Information intermediary:

Telephone:

Bid type: Bid type: Starting bid Final proposal

Bid cost buyer: €

Mortgage in the amount of: €

Financial conditions: Financial conditions: No reservations about obtaining financing Subject to obtaining financing

Construction conditions: Construction conditions: Subject to a building inspection Subject to a building inspection, within the statutory 3 days reflection period

Additional information:

First and last name:

Street + House no.:

Postal code + City:

Telephone:

E-mail address:

I would like to request the following without obligation: I would like to request the following without obligation: Yes, I would like a non-binding valuation of my home Yes, I would like a non-binding valuation of my home

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