Metro Referral Associates - Referral Form

Client Referral Form

Metro Referrals TAX ID# 54-1185624
Metro Referral Agent Information
Name *

First Name Last Name
Phone Number *
E-mail *

Receiving Agent and Broker Information
Receiving Agent Name

First Name Last Name
Receiving Agent E-mail
Agent will receive a copy of this information upon submission for their signature of acceptance
Broker Firm Name
Broker Phone Number
Broker Address

Client Information
Client Type *

BUYER SELLER
Client First Name *
Client Last Name *
Client Address *
Phone Type? *

Cell Work Home
Client Home Phone *
Client Work Phone *
Client Cell Phone *
Best Number to call
Best Time to call
Client E-mail

Additional Seller Information
If the property the client is selling is different from their current address, please complete.
Property Address
Is property a Short Sale?

Yes No Not sure
Is property vacant?

Yes No Not sure

Referral Fee Acceptance
Referring Agent & Receiving Agent agree to the referral fee listed below.

The percentage is based on the

GROSS COMMISSION on the REFERRING SIDE of the transaction.
REFERRAL FEE % *

Referring Agent Signature *

REFERRING AGENT SIGNATURE Clear
Referring Signature Name *

First Name Last Name
Referring Agent Additional Notes

Receiving Agent Signature *

RECEIVING AGENT SIGNATURE Clear
Receiving Signature Name *

First Name Last Name
Receiving Agent Additional Notes

Should be Empty: