A-2-Z TC LLC Services
New Client Intake Form
Listing Coordination
$300
Buyer Agent/Seller Agent Coordination
$300
Dual Agent Coordination
$500
Property Address
*
DD Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Settlement Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
BROKER AND CLIENT CONTACT INFORMATION
Agent Name
*
First Name
Last Name
Cell
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Preferred Contact Method
Broker Company Name and License Numbers
Client's Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Comments - Special Instructions
BUSINESS PARTNER PREFERENCES
PREFERENCES
Home Inspector
Client's Attorney - Name and Contact Information
*
Termite Company
Pool Inspector
Lender Information - Name and Contact Information
Any Comments or Special Instructions
PLEASE TEXT US TO LET US KNOW YOU SUBMITTED A FORM AT (910) 638-1202
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