Listing Agent Form

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Items with an asterisk (*) must be completed even with an “N/A” or “None"

Property Address*

Street Address Address Line 2 City State ZIP Code

Listing Agent’s Assistant and/or Transaction Coordinator Name*

If there is no assistant, type “none”

Listing Agent’s Assistant and/or Transaction Coordinator Email*

If there is no email, type “none”

Listing agent acknowledges that seller(s) who elect to sign separately from the buyer(s) will incur a split-settlement charge of $100.*

Acknowledge

Listing agent acknowledges that any utilities due pursuant to a rent back will need to be agreed to and handled by the parties outside of closing.*

Acknowledge

Broker License No.*

Agent License No.*

Total Commission (% or $)*

Listing Agent %*

Selling Agent %*

Broker/Admin Fee*

Will a home warranty be provided?*

If Yes, Warranty Company*

If no Warranty, type “none”

Who is paying for the Home Warranty*

“If no Warranty, type “none”

HOA/Condo Association Management Co.*

“If no HOA/Condo Association, type “none”

HOA/Condo Association contact information*

“If no HOA/Condo Association, type “none”

Seller email address*

Seller email address

Seller phone number*

Seller phone number