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Date

 

_____________________
 

 
 
Sending Agent
  Name __________________________________
Address __________________________________
City, State ZIP __________________________________
Phone __________________________________
Cel __________________________________
 
 
 
Receiving Agent
  Name __________________________________
Address __________________________________
City, State ZIP __________________________________
Phone __________________________________
Cel __________________________________
 
 
 
Buyer / Seller
  Name __________________________________
Address __________________________________
City, State ZIP __________________________________
Phone __________________________________
Cel __________________________________
 
 
 
Looking to
  [   ] Buy or [   ] Sell Home
Square footage __________________________________
Number of Rooms __________________________________
Number of baths __________________________________
Preferred area __________________________________
Additional comments __________________________________
_______________________________________________
 
 
 
Looking to
  [   ] Buy or [   ] Sell Land
Number of acres__________________________________
Preferred area __________________________________
Additional comments __________________________________
_______________________________________________
 
 
 
Rental
  Square footage __________________________________
Number of Rooms __________________________________
Number of baths __________________________________
Preferred area __________________________________
Additional comments __________________________________
_______________________________________________
   
 
 
  This Agreement, if between two Real Estate Professionals, confirms an understanding that a fee of ______ percent will be paid to the sending agent for sending the referral which results in a closed transactions.
  
 
   
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