BetterNest Realty
Referral Confirmation Form
Date: ___________________________
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.
1. Property Information
Street Address:_______________________________________________________________
City:_______________________________ State:__________________ Zip:____________
2. Seller Information
Owner 1
Name:______________________________________________________
Phone:______________________________________________________
Email:______________________________________________________
Owner 2 (If Applicable)
Name:______________________________________________________
Phone:______________________________________________________
Email:______________________________________________________
3. Agent Information
Agent Name:__________________________________________________
Brokerage:____________________________________________________
License #:_____________________________________________________
Phone:_______________________________________________________
Email:________________________________________________________
4. Closing Agent Information
Title Company:_________________________________________________
Closing Agent:__________________________________________________
Phone:_______________________________________________________
Email:________________________________________________________
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.
Agent Signature: ______________________________________________________ Date: ________________________
