"Real Estate Referral Form"

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Real Estate Referral Form
1. Receiving Agent Information.
_______________________________
_______________________________
Receiving Agent’s Name
Office Name
_____________________________________________________________________
Office Street Address
City
State
ZIP Code
_______________________________
_______________________________
Receiving Agent’s Email Address
Receiving Agent’s Cell Phone
_______________________________
_______________________________
Receiving Agent’s Primary Phone
Receiving Agent’s Fax
2. Referring Agent Information.
_______________________________
_______________________________
Referring Agent’s Name
Office Name
_____________________________________________________________________
Office Street Address
City
State
ZIP Code
_______________________________
_______________________________
Referring Agent’s Email Address
Referring Agent’s Cell Phone
_______________________________
_______________________________
Referring Agent’s Primary Phone
Referring Agent’s Fax
3. Client Information.
_____________________________________________________________________
Client’s Name
_____________________________________________________________________
Current Street Address
City
State
ZIP Code
_______________________________
_______________________________
Client’s Current Home Phone Number
Client’s Cell Phone Number
_______________________________
_______________________________
Client’s Current Work Phone Number
Client’s Email Address
©​ ​ ​ ​
T EMPLATEROLLER.COM​
Real Estate Referral Form
1. Receiving Agent Information.
_______________________________
_______________________________
Receiving Agent’s Name
Office Name
_____________________________________________________________________
Office Street Address
City
State
ZIP Code
_______________________________
_______________________________
Receiving Agent’s Email Address
Receiving Agent’s Cell Phone
_______________________________
_______________________________
Receiving Agent’s Primary Phone
Receiving Agent’s Fax
2. Referring Agent Information.
_______________________________
_______________________________
Referring Agent’s Name
Office Name
_____________________________________________________________________
Office Street Address
City
State
ZIP Code
_______________________________
_______________________________
Referring Agent’s Email Address
Referring Agent’s Cell Phone
_______________________________
_______________________________
Referring Agent’s Primary Phone
Referring Agent’s Fax
3. Client Information.
_____________________________________________________________________
Client’s Name
_____________________________________________________________________
Current Street Address
City
State
ZIP Code
_______________________________
_______________________________
Client’s Current Home Phone Number
Client’s Cell Phone Number
_______________________________
_______________________________
Client’s Current Work Phone Number
Client’s Email Address
©​ ​ ​ ​
T EMPLATEROLLER.COM​
_______________________________
_______________________________
Adults Moving
Children Moving
_______________________________
_______________________________
Next Date of Home Finding Trip
Expected Moving Date
Additional Information: _________________________________________________
_____________________________________________________________________
_____________________________________________________________________
4. Current Property Information.
Estimated Property Listing Price
Reason for Moving
Additional Information: _________________________________________________
_____________________________________________________________________
_____________________________________________________________________
5. Desired Property Information.
Price Range:​
_____________________
Number of Bedrooms: _____________
Estimated Down Payment: __________
Number of Baths:​
_ ________________
Desired Monthly Payment:​
_ _________
Square Footage: __________________
Preferred Home Style:​
_ __________________________________________________
Preferred Area: ________________________________________________________
School Requirements: ___________________________________________________
Additional Requirements: ________________________________________________
_____________________________________________________________________
_____________________________________________________________________
6. Referral Agreement Details.
An agreed-upon referral fee of $____________________ will be paid by the receiving
agent to the referring agent.
©​ ​ ​ ​
T EMPLATEROLLER.COM​
The referral fee will be based on: __________________________________________
_____________________________________________________________________
_______________________________
_______________________________
Referring Agent’s Signature
Receiving Agent’s Signature
_______________________________
_______________________________
Date
Date
©​ ​ ​ ​
T EMPLATEROLLER.COM​
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