BetterNest Realty
Referral Confirmation Form
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Date: ___________________________
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This form confirms that the following real estate transaction originated from a referral provided by BetterNest Real Estate Group, LLC, doing business as BetterNest Realty, pursuant to the BetterNest Referral Partner Agreement.
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1. Property Information
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Street Address:_______________________________________________________________
​ City:_______________________________ State:__________________ Zip:____________
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2. Seller Information
Owner 1
Name:______________________________________________________
Phone:______________________________________________________
Email:______________________________________________________
Owner 2 (If Applicable)
Name:______________________________________________________
Phone:______________________________________________________
Email:______________________________________________________
3. Agent Information
Agent Name:__________________________________________________
Brokerage:____________________________________________________
License #:_____________________________________________________
Phone:_______________________________________________________
Email:________________________________________________________
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4. Closing Agent Information
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Title Company:_________________________________________________
Closing Agent:__________________________________________________
Phone:_______________________________________________________
Email:________________________________________________________
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5. Referral Fee​
Referral Fee: 25% of the Agent’s Gross Commission
6. Authorization
​By signing below, the Agent acknowledges that this transaction originated from a BetterNest Referral and authorizes the closing company to disburse the referral fee to BetterNest Realty, LLC at closing.
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​Agent Signature: ______________________________________________________​ Date: ________________________
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