Please print out the form below and send it to Glen Frederich

Fax: 866-725-3844

WORKING WITH REAL ESTATE AGENTS

This is not a contract

By signing, I acknowledge that the agent named below
furnished a copy of this brochure and reviewed it with me.


_____________________________________________
Buyer or Seller Name (Print or Type)


_____________________________________________
Buyer or Seller Signature


_____________________________________________
Buyer or Seller Name (Print or Type)


_____________________________________________
Buyer or Seller Signature


_____________________________________________
Date


_____________________________________________
Firm Name


_____________________________________________
Agent Name


Disclosure of Seller Sub agency

When showing you property and assisting you in the
purchase of a property, the above agent and firm will
represent the SELLER. For more information, see “Seller’s
Agent Working with a Buyer” in the brochure.

Buyer’s Initials Acknowledging Disclosure: _____________

Agents must retain this acknowledgment for their files.