Clone of Offer Submission Form

Buyer Brokerage Agreement Preparation
Brokerage Firm Name
example@example.com
Agent Name

First NameLast Name
Agent Email
example@example.com
Agent Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Are you representing buyer as client or customer?
Buyer #1 Full Legal Name

First NameLast Name
Buyer #1 Email
example@example.com
Buyer #1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Buyer #2 Full Legal Name

First NameLast Name
Buyer #2 Email
example@example.com
Buyer #2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Agreement Start Date

MonthDayYear
Date
Agreement End Date

MonthDayYear
Date
Agency NOT Offered
Value of Broker's Professional Service Compensation Percentage: (if applicable)
Value of Broker's Professional Service Flat Fee: (if applicable)
Other Compensation Description: (if applicable)
28. Does Buyer direct Broker to seek compensation from Seller or Seller’s Broker?
LEASE COMPENSATION (IF APPLICABLE) - If Buyer enters into a lease during this agreement, is separate leasing compensation required?
Leasing Compensation Amount (if applicable)
Leasing Compensation Terms (if applicable)
PROTECTED PERIOD: Length of Protected Period (in days) (Example: 30, 60, 90)
SPECIAL STIPULATIONS: Are there any Special Stipulations to be added?
If yes, please provide Special Stipulations text:
✅ AGENT AUTHORIZATIONI authorize the TC to draft this offer exactly as submittedI confirm all information is accurateI understand changes after drafting may delay submission
Special Stipulations:

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Prepare Buyer Brokerage Agreement

$65 -Administrative preparation of the Buyer Brokerage Agreement.

$65.00

Total

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First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

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Buyer Brokerage Agreement Preparation

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