Step 1 of 6 16% Click here if you want TOP REALTORS CANADA to distribute your referral I Know What Agent to Refer to Receiving Agent InformationAgent Name*Office Name*Address Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Email* Primary PhoneCellphone Sending Agent InformationAgent Name*Office Name*Address Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Sending Agent Email* Primary PhoneCellphone Client InformationNameCurrent Address Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code PhoneNext Date of Home Finding Trip MM slash DD slash YYYY Expected Move Date MM slash DD slash YYYY Additional Information Current Property InformationClient is aEstimated property listing priceMust clients sell first? Yes No Has client been pre-qualified? Yes No Lender Information:Reason for move? Desired Property InformationPrice RangeEst. Down PaymentDesired Monthly PaymentPreferred Home Style? Single Family Home Condo / Town Home Other Number of BedroomsNumber of BathroomsSquare FootageFamiliar with the area? Yes No Preferred AreaSchool Requirements Elementary Jr. High Sr. High College Additional Requirements Referral Agreement DetailsBy 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 OfferedPercentage-based referral fees will be based on commissions earned on theListing SideSelling SideOther (Please Specify)SignaturesBy 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 NameSending Agent Full NameDate MM slash DD slash YYYY CAPTCHA
