Is there more than 1 Seller?
*
Please Select
Yes
No
Seller 1 Name
*
Copy of Seller 1 Identification
*
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Seller 2 Name
*
Copy of Seller 2 Identification
*
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Brokerage
Listing Start Date
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-
Month
-
Day
Year
Date
Listing Term Duration
Listing Termination Date:
*
-
Month
-
Day
Year
Date
Property Address:
*
Are you including any personal property in the sale, including appliances:
*
Amendment for legal description
See Attachment
How much would you like to offer the property for sale?
*
The following Financing Terms are acceptable to Seller Financing:
*
Cash
Conventional
VA
FHA
Other
Regarding Compensation: (select one)
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Seller authorizes Broker to offer compensation to buyer's broker in the amount of: ____% of the purchase price or $ ____.
Seller authorizes Broker to communicate Seller's offer of compensation to buyer's broker in the amount ___% of the purchase price or $______.
No compensation will be offered to a buyer's agent.
Seller is offering buyer broker compensation in the amount of ____ % the purchase price (only select one)
Seller is offering buyer broker compensation in the amount of $____ the purchase price (only select one)
Seller authorizes Broker to communicate Seller's offer of compensation to buyer's broker in the amount of ___% the purchase price (only select one)
Seller authorizes Broker to communicate Seller's offer of compensation to buyer's broker in the amount of $___ the purchase price (only select one)
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Brokerage Relationship
act as a transaction broker
act as a single agent of Seller
act as a single agent of Seller with consent to transition to transaction broker
have no brokerage relationship with Seller
Seller 1 Signature:
*
Date:
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Month
-
Day
Year
Date
Seller 1 Phone Number
*
Format: (000) 000-0000.
Seller 1 Address:
*
Seller 1 Email Address:
*
example@example.com
Seller 2 Signature:
*
Date:
-
Month
-
Day
Year
Date
Seller 2 Phone Number:
*
Format: (000) 000-0000.
Seller 2 Address:
*
Seller 2 Email Address:
*
example@example.com
Broker or Authorized Associate:
Date:
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Month
-
Day
Year
Date
Brokerage Firm Name:
Telephone:
*
Format: (000) 000-0000.
Brokerage Address:
*
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Seller 1 Signature (amendment):
Date:
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Month
-
Day
Year
Date
Seller 2 Signature (amendment):
Date:
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Month
-
Day
Year
Date
Preview PDF
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