Agent Referral Form
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Complete Agent Referral Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
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1RE/MAX Agent Referral Form
Sending Agent Information
Receiving Agent Information
Agent Name:________________________________
Agent Name:________________________________
Office Name:________________________________
Office Name:________________________________
Address:____________________________________
Address:____________________________________
City:_______________________________________
City:_______________________________________
State/Prov:________ Zip/PC:___________________
State/Prov:________ Zip/PC:___________________
Country:____________________________________
Country:____________________________________
E-mail:_____________________________________
E-mail:_____________________________________
Primary Phone:______________________________
Primary Phone:______________________________
Cell Phone:_________________________________
Referring Office Tax ID Number:________________
Cell Phone:_________________________________
Fax Number:________________________________
Fax Number:________________________________
Client Information
Current Home Phone Number:__________________________
Name:______________________________________________
Current Address:_____________________________________
Current Work Phone Number:___________________________
City:_______________________________________________
Cell Phone Number:__________________________________
State/Prov:____________ Zip/PC:_______________________
Number of Adults in move:____________________________
Country:____________________________________________
Number of Children in move:___________________________
Additional Information:________________________________
Next Date of Home Finding Trip:________________________
Expected Move Date:_________________________________
___________________________________________________
Current Property Information
Client is a:________________________________ Estimated property listing price:_______________ Must clients sell first:_____
Has client been pre-qualified?___________ 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_________ Other______________________ _____
Number of Bedrooms:________________ Number of Baths:________________
Square Footage:_____________________
Familiar with the area:______________________ Preferred Area:_____________________________________________________
School Requirements:
Elementary_________
Jr. High___________
Sr. High__________
College____________
Additional Requirements:______________________________________________________________________________________
Referral Agreement Details
By signing this form as the receiving agent, ______________________________________, agrees to have his/her broker-in-charge pay
an agreed upon referral fee of: _________% or $_______________ flat fee, 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:
Listing side ______ Selling side ______ Other (please specify) _______________________________________________________.
Sending Agent Signature:__________________________________________________________
Date:_____________________
Receiving Agent Signature:_________________________________________________________ Date:_____________________
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Parent category: Business