iRealty Virtual Brokers Buyer Referral Form
Referring Broker/Agent
Date of Referral Agreement
-
Month
-
Day
Year
Date
Brokerage Name
Referring Broker Name
First Name
Last Name
Email
example@example.com
Business Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Requested Referral Fee
Commissions Cannot Be Paid to Non-Licensees
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Receiving Broker/Agent
Name
First
Last Name
Company Name
Email
Web Site
Business Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Texting Number
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Client Referred
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Fax Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Client Particulars
Property Needs
Is this property for the client’s personal use, or is it intended as an investment?
Does this client own other real property in the destination country?
Referring Broker/Agent Prior Experience with this client
Comments
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