BUYER’S REGISTRATION FORM

Date:

This is to formally register our client as prospective buyer for your property located in
, which I have offered for sale.

NAME/S NAME/S

It is understood that should any of these client or family members or company they
represent or part-owner, bought the property you own/sell, we are entitled to a ____%
professional fee of the accepted Purchase Price, as agreed in the issued Authority To
Sell.

MICHELLE REYES
Real Estate Agent

ELLA BRIONES
REB # 00188

Conforme:

___________________________________________________

Seller/Owner/Authorized Representative