Cross Country – Referral Form

Lead Contact Information
Name
First Last
Phone
Email
Lead Type*
- Buyer
- Seller
If lead is a buy and sell please choose "Seller".
What marketplace are they looking in?*
City of Interest?*
City
Lead's Timeframe for Purchase*
- 0-30 Days
- 30-60 Days
- 60-90 Days
- 90+
Estimated Purchase Price*
*Numbers only
Notes to share with Agent*
Loan Officer Information
Name
First Last
Email
Phone & Ext.
What is the leadsource of this client?*
- Agent Zip
- Cardinal - Coomer Team
*Cardinal Consumer Direct = Cardinal Organic

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