Referral Intake Form
Client-To-Agent Matchmaker: Match Buyers and Sellers with Experienced and Talented Realtors!
Refer Only Agent's Information
Is your Client already working with this Realtor or another Realtor? If so - do not complete this form and call Taunee 310-927-6155 before proceeding any further.
*
Please Select
Yes
No
Name:
*
First Name
Last Name
E-mail:
*
example@example.com
Phone Number:
*
Format: (000) 000-0000.
Client Referral Details
YOUR BUYER'S OR SELLER'S INFORMATION
Buyer or Seller?
*
Please Select
Buyer
Seller
Client's Name #1:
*
First Name
Last Name
Client's Name #2:
First Name
Last Name
Best E-mail:
*
example@example.com
Best Phone Number:
*
Format: (000) 000-0000.
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How do you know the Client?
*
For Seller Clients - What type of property?
*
Please Select
Single Family.
Condo
Single Family - Rental Property
Condo - Rental Property
Multi-Family - under 4 units
Multi-Family
Commercial - Industrial
Commercial - Office
Commercial - Retail
Client Language Preference?
Please Select
English
Spanish
Chinese
French
Korean
Vietnamese
Japanese
Specific Specialty Preference:
Please Select
First Time Homebuyer
Short Sales and Foreclosure - Distressed Properties
Divorce
Probate
Retirement Communities
Commercial - non Multi-Family
Commercial - Multi-Family
Vacant Lot/Land
Luxury
How soon is your Client ready to Sell or Purchase?
*
Please Select
Within 30 days
Within 60 days
Within 90 days
Within 120 days
Is the Buyer's Cash Buyer?
*
Please Select
Yes
No
Is the Buyer Client pre-approved?
*
Please Select
Yes
No
What is the Buyer's maximum purchase price?
*
What is the Buyer's down-payment?
Please Select
3.5%
5%
10%
20%
50%
What type of property does your Buyer desire to purchase?
*
Single Family - Detached
Townhome - Attached
Condo - single story - Attached
Retirement Community
Multi-Family (4 units or less)
Multi-Family
Commercial - Office
Commercial - Industrial
Commercial - Retail
For Buyer Clients - what is the minimum living space square footage?
Please Select
500 sqft
800 sqft
1000 sqft
1500 sqft
2000 sqft
3000 sqft
4000 sqft
5000 sqft
over 6000 sqft
For Buyer Clients - what is the minimum bedroom requirement?
Please Select
1
2
3
4
5
6
7
For Buyer Clients - what is the minimum bathroom requirement?
Please Select
1
1.5
2
3
4
5
6
Do you have a Realtor you prefer to refer your client to?
*
Please Select
Yes
No
Your Prefer Realtor's Name:
Your Prefer Realtor's Brokerage Name:
Your Prefer Realtor's Broker's Name or Manager's Name:
Your Prefer Realtor's Email:
Your Prefer Realtor's Broker's Name or Manager's Email:
Your Prefer Realtor's Cell Number:
Please enter a valid phone number.
Format: (000) 000-0000.
Your Prefer Realtor's Broker or Manager's Phone Number:
Please enter a valid phone number.
Format: (000) 000-0000.
Referral Fee?
*
Please Select
25% - Buyer
30% - Seller
Does your Client know that they are being referred, and you disclosed that you'll be receiving a referral fee?
*
Please Select
Yes
No
Is your Preferred Realtor aware of the Referral?
Please Select
Yes
No
Submit
Should be Empty: