Agent Referral Form

Thank you for your referral! I appreciate your confidence and will respond to
you and your client promptly.

Client Contact Information

Is your client  buying or selling?

Client Name:

Client Address (Street/P.O.B.):

Client City, State, Zip:

Client Phone, with area code:

Best phone number to contact client:

Client Fax:

Client Email Address:

Person to contact:

Best Time to Call:

Is the client already aware that I will be contacting them?

Referring Agent Information

Your Name:

Your Firm Name:

Mailing Address (Street/ P.O.B.):

City, State, Zip:

Daytime Phone (with area code):

Evening Phone (with area code):

Fax (with area code):

Email Address:

About Buyer

What is your association with the client?

Does the client have also have a property to sell?

If so, is the property currently listed?

What is the list price?

MLS#

Within what time-frame does the client want to buy or sell?

Buyers Price Range:

Area/city in which the buyer is interested in purchasing:

Further comments/questions: