Buyer Agency Intake
Name
First Name
Last Name
Email
example@example.com
Buyer 1 Name
First Name
Last Name
Buyer 1 Email
example@example.com
Buyer 2 Name
First Name
Last Name
Buyer 2 Email
example@example.com
Expiration Date
-
Month
-
Day
Year
Date
Firms Fee
3%
2.5%
2%
Other
Agency
Dual Agency Allowed
Dual Agency NOT Allowed
If Firm may act as a dual agent
Buyer Authorized Dual Agency
Buyer Does NOT Authorize Dual Agency
Buyer will Allow Designated Dual Agency
Any Additional Terms
Submit
Should be Empty: