TM Referral Agreement Request
Your Name:
*
First Name
Last Name
Your Email Address: (you will get a copy of this form once submitted)
*
example@azhomes.com
Is this Referral an:
*
Incoming Referral (is another agent sending you this client)
Outgoing Referral (are you sending this client to another agent)
Receiving Brokerage Name:
*
Receiving Agent Name:
*
Receiving Agent's Office Address:
*
Receiving Agent Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Receiving Agent Email
*
example@example.com
Client Name:
*
Client Address
Client Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Client Email
example@example.com
Is this client a:
*
Buyer
Seller
Referral Fee Amount (in % of $):
*
Additional Terms or Conditions of Referral:
Term Start Date:
*
-
Month
-
Day
Year
Date
Term Expiration Date (may not be more than 1 year):
*
-
Month
-
Day
Year
Date
Do you have the client's consent to initiate the referral:
*
Yes
No
Is the client represented by a Relocation Company:
*
Yes
No
Once document is signed, do you want TM Team to deliver to cross agent?
*
Yes
No
Additional info/notes for TM Team:
Attach additional documents here if we do not already have them. (If we have the documents, please do not upload) ie...contract, BINSR, Bids, etc.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit
Should be Empty: