PENNSYLVANIA BUYER form:

$395 flat fee paid by:

Buyer

Agent

Referral agreement completed?

Yes

No

N/A

Buyer LEGAL Name 1 (ON DRIVER'S LICENSE) *

First Name

Last Name

Phone

(###)

###

####

Buyer LEGAL Name 2 (ON DRIVER'S LICENSE)

First Name

Last Name

Primary Residence or Investment Property?

Primary Residence

Investment Property

Martial Status of buyer if not an LLC?

Married

Divorced

Currently going through a divorce

Single

If single buyer, will an LLC be formed prior to closing?

Yes

No

Condo Association?

Yes

No

Is this part of a 1031 exchange?

Yes

No

I'm not sure

Commission Split:

Higher

Lower

If there is seller assist is commission paid off net or gross ?

Net

Gross

Who is paying commission/compensation?

Listing Brokerage

Paid by client

Buyer agency agreement signed?

Yes

No

Co-op broker signed?

Yes

No