Agent Name *

First Name

Last Name

Agent Phone *

(###)

###

####

Property address of listing *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name of Seller #1 *

First Name

Last Name

Seller #1 Phone *

(###)

###

####

Name of Seller #2

First Name

Last Name

Seller #2 Phone

(###)

###

####

Seller Address (if different than listing)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Did we do the pre-listing paperwork on this property? *

Yes

No

Is there an outside referral payout on this transaction?

Yes

No

Should clients be charged any fees on listing agreement?

Yes

No

Are you wanting the FULL Contract to Close Package? *

$425

Yes

No

Do you want to add the Compliance Package? *

$175

Yes

No

Have you read the Kim Bryant Creative Partnership Disclaimer and limitations-Waiver? By clicking yes, you have signed that you agree with this waiver. *

Yes, I have read the waiver.