Buyer Broker Participation Terms Referral Form (Page 2 of 2) in pdf

Buyer Broker Participation Terms Referral Form Page 2

Buyer Broker Registration Form

Don't forget - this form must be submitted, at least, 48 hours prior to the auction.

All information fields must be completed or your registration may be rejected.

AUCTION PROPERTY INFORMATION

Reference #: ____________________________________

Address: ____________________________________________________________________

City: ____________________________________ State: _________________ Zip: __________

OPENING BID

(required)

Amount: $ ____________________________________________

*You must submit an opening bid of at least 70% of your customer's winning bid or you will not earn a

commission.

BROKER INFORMATION

Company Name: _______________________________________________________________

Address: _____________________________________________________________________

City: ________________________________ State: _____________________ Zip: _________

Phone: ________________________________ Fax: __________________________________

Email: _______________________________________________________________________

Broker Name: _________________________________________________________________

Real Estate License #: ______________________________ Expiration Date: ______________

BUYER INFORMATION

Name: ___________________________________________________________________

Company: ________________________________________________________________

Address: _________________________________________________________________

City: _______________________________ State: _____________________ Zip: _______

Phone: _____________________________ Fax: ________________________________

Email: ____________________________________________________________________

An affidavit stating that neither broker, nor any of his employees or agents, nor any member of their

immediate family, is a principal will be required to be signed at the auction.

PLEASE COMPLETE and FAX COMPLETED FORM TO:

ROBERT L. BLACKFORD

270-726-1407

Buyer Broker Participation Terms Referral Form Page 2