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    Name* :
                       Surname* :  
 
  
    City :    
                       Country :    
 
  
 Phone number : 
 E-mail* : 
                      Confirm E-mail* : 
  
Tick if you would like to be contacted by our selected currency partners to receive more information about currency exchange for your property purchase or sale:   Location (Rural, town, etc...) : 
 
 
Type of home (rustic, rural, cave, etc.)
: 
  
Approximate budget (€) : 
 
Intended use for home (e.g. Holidays, Relocation, Renovate to resale, Investment): 
 
Condition of home (Ready to move in to, Cosmetic - paint and decorate, for the advanced DIY'er, Full renovation) : 
 
Amount of garden / land wanted - if any : 
 
Where did you learn about Rusticom? : 
 
Comments and other information that
could help us find you the home you are looking for* :  
 
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