INTEROFFICE REFERRAL CONFIRMATIOM FORM For use when placing a referral with another CBRB agent in MA, NH, RI or ME

DATE:

FROM: Referring Associate Name: Office (City, State): Phone: Email:

TO: Receiving Associate Name: Office (City, State): Phone: Email:

CUSTOMER INFORMATION: Customer Name(s): Current Address:

City, State, Zip: Home Phone: Cell Phone: Email:

Type of Referral: Seller Buyer

For Listings: Listing Address: City, State, Zip:

For Buyers: Location Preference: Type of Home Desired: SFH Condo Townhouse Multi Land Price Range: $ Specific Needs or Instructions:

REFERRAL FEE IS 25% OF THE REFERRED FUNCTION SIDE Your signature acknowledges your acceptance of this referral.

SIGNATURE OF RECEIVING ASSOCIATE:______

Please provide regular updates to the Referring Associate.

Copies of this agreement should be provided to: Referring Associate & Manager Receiving Associate & Manager