Broker Referral

Real Estate Buyer Broker Participation Form

Auction *

Auction Date *

Auction Property Address

Street Address

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Opening Bid *

Buyer Information

Name *

First Name

Last Name

Buyer Address *

Street Address

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Buyer Daytime Phone *

Area Code

Phone Number

Buyer Email *

Buyer Cell Phone *

Area Code

Phone Number

Buyer Fax

Area Code

Phone Number

Real Estate Broker Information

Broker Name *

First Name

Last Name

Broker Address *

Street Address

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Company *

Real Estate Broker Name and License *

State *

Broker Daytime Phone *

Area Code

Phone Number

Broker Email *

Tax ID# *

Broker Cell Phone *

Area Code

Phone Number

Broker Fax

Area Code

Phone Number

Broker Acknowledgement

I expressly acknowledge and agree to the following Terms and Conditions: 1. I have read, signed, and agree to be bound by, the Terms and Conditions of Participation for the Auction Sale of the above Property; 2. A commission of 20% of the 10% Buyers Premium charge or 20% of any negotiated commission will be paid to any properly licensed real estate broker/agent whose BUYER/BIDDER is the successful purchaser for this property, and who actually closes and pays the total CONTRACT PRICE AND CLOSING COST for this property. To qualify for a commission, the Broker/Agent must first register their prospect on this MANDATORY REAL ESTATE BUYER BROKER PARTICIPATION REGISTRATION Form. This form must be received by Fred Wilson Auction Service, LLC prior to a Broker/Agent's client attending any open houses, private showing and or bidding on the auction in order for the Broker to be eligible for a commission. NO LATE REGISTRATIONS WILL BE ACCEPTED. Brokers/Agents are required to attend the auction with the registered client(s) as well as any open houses or private showings the Broker/Agent's client attends. Brokers/Agents whose prospects who have had previous contact with the auction company and or the Seller are not eligible for a commission. Broker/Agent shall not be intitled to a commission on account of any sale to any entity of which (or any affiliate of which) the real estate Broker/Agent is a principal, employee, affiliate, or immediate family member. Commissions will be paid only after closing and after Fred Wilson Auction Service, LLC has been paid in full. If a cooperating Broker/Agent has not met all of these requirements, no commission will be paid to the cooperating Broker/Agent, even if the cooperating Broker/Agent's client purchases the Property(s). No oral registrations will be accepted. Under no circumstances whatsoever will any commission be paid if the sale does not close for any reason. 3. The Licensed Real Estate Broker above acknowledges that it represents the Buyer, not the Seller, in the above referenced Auction and agrees to indemnify and hold harmless the Seller, and Fred Wilson Auction Service LLC from any claims, costs, and expenses, including attorney’s fees, arising out of any acts performed or representations made by them in connection with the participation at the Auction of the purchase and sale of the above references Property(s) purchased at the Auction or otherwise. By checking this box, I acknowledge that I have read and understood the Broker Acknowledgement above.

Terms and Conditions Acknowledgement *

I acknowledge that I have read and understand the Broker Acknowledgement.

Real Estate Buyer Broker Participation Form

Buyer Information

Real Estate Broker Information

Broker Acknowledgement

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