Client Buyer Intake Form

CLIENT BUYER INTAKE FORM & BUYER REPRESENTATION AGREEMENT

Identification of Parties

Client Name:

Broker/Representative:

WHEREAS / Recitals

WHEREAS, Client desires professional assistance in locating, evaluating, and acquiring real property and related services; and Broker has the experience, license and capacity to provide such services;

WHEREAS, Client hereby engages Broker as Client's exclusive buyer representative for the Term defined below, subject to the terms and conditions set forth in this Agreement; and Broker accepts such engagement on the terms specified herein.

WHEREAS, the parties intend through this Intake Form to record Client's preferences, financial qualifications, and authorize Broker to perform the Scope of Work described below and to obtain necessary verifications.

Client Contact Information

Phone Email Text

Buyer Profile & Property Preferences

Residential Condominium Multi-Family Land Other:

Bedrooms: to    Bathrooms: to

Financial Qualifications

Pre-approval Status: Yes No

Scope of Work

Broker shall use commercially reasonable efforts to identify and present properties, accompany Client to showings, advise on market value, prepare and present offers, negotiate terms, and coordinate closing activities. Specific tasks and limitations to be set forth below:

Payment Terms

Commission or Fees: Client acknowledges that commission or fees may be payable on successful purchase as follows. If seller compensation does not fully satisfy Broker's fee, Client agrees to pay the remainder as set forth below.

Payment Schedule:

Late Fee: If Client fails to pay amounts due that Client is obligated to pay under this Agreement, interest shall accrue at or the maximum permitted by law, whichever is less.

Term and Termination

Term Commencement Date:   Term Expiration Date:

Either party may terminate this Agreement upon written notice to the other party. Notice period: days. Termination shall not relieve Client of liability for fees earned prior to termination, nor for fees arising from transactions initiated during the Term but closed after termination as expressly provided herein.

Confidentiality

All non-public information exchanged between the parties in furtherance of this engagement, including but not limited to financial information, negotiation positions, and offered terms, shall be treated as confidential and shall not be disclosed to third parties except as required to perform the services or as required by law. Broker shall use reasonable safeguards to protect Client information.

Confidentiality Agreement Acknowledged:

Authorizations and Certifications

Client authorizes Broker to obtain credit, employment, and asset verification as necessary to evaluate financing and to prepare offers. Client certifies that the information provided in this Intake Form is true, accurate and complete to the best of Client's knowledge, and agrees to promptly notify Broker of any material change.

Authorization to Verify:

Governing Law; Entire Agreement

This Agreement shall be governed by and construed in accordance with the laws of: with venue in the appropriate courts of that jurisdiction unless otherwise agreed in writing.

Entire Agreement: This Intake Form and any attachments constitute the entire agreement between the parties with respect to the subject matter herein and supersede all prior negotiations, representations, or agreements, whether oral or written. No amendment shall be effective unless in writing and signed by both parties.

Acknowledgment

By signing below, Client acknowledges receipt of this Intake Form and Agreement, confirms the accuracy of the information provided, and appoints Broker to act as Client's buyer representative under the terms set forth above.

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