Real Estate Agent Referral Form Real Broker, LLC accepts this referral ...

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Real Estate Agent Referral Form 
 Receiving Agent Information Agent Name _______________________________ Office Name _______________________________ Address___________________________________ City ______________________________________ State ________________ Zip _________________ Email Address _____________________________ Phone ____________________________________ Fax ______________________________________ Client Information 
 Name_____________________________________ Current Address ____________________________ City ______________________________________ State____________ Zip ______________ Additional Information ________________________ ____________________________________________ ____________________________________________ ____________________________________________

Referral Agent Information Agent Name _______________________________ Office Name _______________________________ Address___________________________________ City ______________________________________ State ________________ Zip _________________ Email Address _____________________________ Phone ____________________________________ Fax ______________________________________ 
 Home Phone Number _______________________ Work Phone Number ________________________ Cell Phone Number _________________________ Email Address _____________________________ No. of Adults in move _______ No. of Children ____ Next Date of Home Finding Trip________________ Expected Moving Date _______________________ 


Current Property Information Client is a _________________ Estimated Property Listing Price ______________Client Must Sell ___________ Has Client been Pre-Qualified?___________________ Lender Information ______________________________ Reason for Moving ____________________________________________________________________________
 ____________________________________________________________________________________________ ____________________________________________________________________________________________
 Desired Property Information Price Range _______________ Estimated Down Payment___________ Desired Monthly Payment __________ Preferred Home Style: Single Family Home _____ Condo/Town Home _____ Other ______________________ Number of Bedrooms _______ Number of Baths ________ SquareFootage _____________________________ Familiar with the area?_______________ Preferred Area _____________________________________________ School Requirements: Elementary ________ Jr. High _________ Sr. High_________ College ________________ Additional Requirements _______________________________________________________________________ ____________________________________________________________________________________________ Referral Agreement Details An agreed upon referral fee of ________________ will be paid by the receiving agent to the referring agent. The referral fee will be based on: Listing ________ Selling _______ Commission ________
 Referring Agent Signature________________________________________ Date________________________ Receiving Agent Signature________________________________________Date________________________

Real Broker, LLC accepts this referral once sale is complete. At that time we agree to send ____ % of gross buying / listing (circle one) side of the sale. Details of sale enclosed with referral check.