Make A Referral RE/MAX Agent Referral Form Receiving Agent Information Sending Agent Information Agent Name Agent Name Office Name Office Name Address Address City Province / State City Province / State Zip Code / Postal Code * Country Zip Code / Postal Code Country Email Email Primary Phone Primary Phone Cellphone Referring Office Tax ID Number Fax # Fax # Client Information Name Current Address City Zip/PC Province/State Country Current Home Phone Number Current Work Phone Number Cell Phone Number Next Date of Home Finding Trip Expected Move Date Additional Information Current Property Information Client is a Estimated property listing price Must clients sell first? Yes No Has client been pre-qualified? Yes No Lender Information: Reason for move? Desired Property Information Price Range Est. Down Payment Desired Monthly Payment Preferred Home Style? Single Family Home Condo/Town Home OtherOther Number of Bedrooms Number of Bathrooms Square Footage Familiar with the area? Yes No Preferred Area School Requirements Elementary Jr. High Sr. High College Additional Requirements Referral Agreement Details By signing this form as the receiving agent, the receiving agent agrees to have his/her broker-in-charge pay an agreed upon referral fee of a set % percentage or set $ flat fee listed below, to the sending agent's broker-in-charge, for the benefit of the sending agent, Percentage-based referral fees will be based on commissions earned on the: % Percentage Fee Offered $ Flat Fee Offered Percentage-based referral fees will be based on commissions earned on the Listing Side Selling Side Other (Please Specify) Signatures By typing your name below you are agreeing to have your entered name act as a legally binding signature. We will also contact you directly to have you legally sign this online form. Please enter your name below: Receiving Agent Full Name Sending Agent Full Name Date Δ Do You Have Questions Or Want To Contact Us? Connect With Us Today
