Offer Request Form

Offer Request Form
If you are a NEW agent and have never worked with us before, please submit a New Agent Intake Form before proceeding with your request.

Contact Information
Agent Name*

First NameLast Name
Buyer Name*

First NameLast Name
Buyer Email*
example@example.com
Buyer Phone*
Please enter a valid phone number.
Are there any additional buyers?*

YesNo
Buyer 2 Name*

First NameLast Name
Buyer 2 Email*
example@example.com
Buyer 2 Phone*
Please enter a valid phone number.
If applicable, please input contact information for any other additional Buyers below.
First Time Homebuyer Y/N*

YesNo

Financing
Financing Type*

NONEConventionalFHAVAUSDAHard MoneyOther
Additional Financing / Homebuyer Assistance Programs, if applicable (for example: MMP, SmartBuy, HAP, etc.)
Loan Application # of Days*
Loan Commitment # of Days*
Loan Amount*
Interest Rate*
Lender Required Repairs Amount ($)*
Please upload the Pre-approval Letter

Cancelof

Additional Terms (if applicable)
Additional Terms (CHECK ALL THAT APPLY)

Purchase Price EscalationAppraisal WaiverBuyer's Sale, Financing, Settlement, or Lease of Other Real EstateShort SaleOther
Purchase Price Escalation Increments*
Purchase Price Escalation Cap*
Buyer's Property Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
The Contract is contingent upon the settlement of Buyer's Property on or before ENTER DATE*.
Third Party Approval # of Days*
OTHER Terms (please be specific)*

Submission
Will you be requiring Contract to Close services if the offer is accepted?*

YesNo
Do you need a Buyer Agency Agreement? (An additional $15 will be applied.)*

YesNo
Buyer Agency Commission*
Buyer Agency Flat Fee*
TERMS OF PAYMENT

Service Fees:
$75 – Offer Writing

Payment Authorization:
By submitting this form, you authorize the card on file to be charged for the selected service.

Revision Policy:
Includes up to 2 revisions & submissions of the offer.

Refund & Cancellation Policy:
All payments are non-refundable once work has commenced. If you wish to cancel your request, you must notify us immediately. Cancellations will not be accepted after work on your file has begun.
Do you agree to the Terms of Payment above?*

Agree
Should be Empty: