AGENT : You Control the Deal and Closing
Name
*
Company
*
Type "n/a" if not applicable
Email
*
example@example.com
Mobile Number
*
Please enter a valid phone number.
Agent Company
*
Address of property
*
Street number and Street name
What Party do you represent?
*
Buyer
Seller
Party's Name(s) and marital status (if company, where incorporated)
*
Who is paying Home Warranty
*
Buyer Agent
Seller Agent
Other (Please explain*)
* Please explain
Type "n/a" if not applicable
Home Warranty Company
*
Type "n/a" if not applicable
Warranty invoice amount
*
Type "n/a" if not applicable
Sellers Agent Commission
blanks
*
%. Buyers Agent Commission
blank
*
%.
Do you want your commission wired?
*
Yes
No
If "No" please state how
*
Type "n/a" if not applicable
Are you/your firm retaining earnest money?
*
Yes
No
Other
Other Instructions:
*
Type "n/a" if not applicable
Submit
Should be Empty: