Transaction Intake Form
Agent Name:
Brokerage:
License Number:
Cell Phone Number:
Email:
Agent represents:
Buyer
Seller
Both
Cooperating Agent Name:
Brokerage:
Cell Phone Number:
Email:
example@example.com
Agent Commission:
Contract Information
MLS Number:
Property Address:
Sales Price:
EMD Amount:
Represented Client 1 Name:
Client 1 Email:
example@example.com
Client 1 Cell Phone Number:
Represented Client 2 Name:
Client 2 Email:
example@example.com
Client 2 Cell Phone Number:
Contract Effective Date:
/
Month
/
Day
Year
Date
Closing Date:
/
Month
/
Day
Year
Date
Home Warranty:
Yes
No
Warranty Company Name and Contact Info:
Home Warranty Paid by:
Seller
Buyer
Agent
Financing:
Yes
Cash
Lender Contact
Company:
Name:
Cell Phone Number:
Escrow/Attorney
Company:
Name:
Contact Phone Number:
Home Inspection:
Scheduled
Needs to be scheduled
Preferred Date
/
Month
/
Day
Year
Date
Home Inspector:
Company:
Name:
Cell Phone Number:
Browse Files
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of
Submit
Should be Empty: