John Collins

Referred Date:
Submission Method:
Transaction Type:
SECTION 1:
Referring Office: Please complete sections 1,2,3,4, or 5 when sending a client referral.
Company:
Address:
City:
Province:
Postal Code:
Telephone:
Referring Salesperson:
Salesperson’s Account #:
Salesperson’s Email:
Real Estate Branch #:
Manager’s Account #:
SECTION 2:
Receiving Office: John Collins will complete section 6 and return a copy to the referring office.
Company:	Royal LePage Signature Realty
Address:	49 The Donway West
City:	Toronto
Province:	Ontario
Postal Code:	M3C 3M9
Telephone:	1 888 954 4100
Email:	jocollins@trebnet.com
Assigned Agent:	John Collins
SECTION 3:
CLIENT INFORMATION
Name:
Address:
City:
Province:
Postal Code:
Reason for this move:
Spouse:
# of Children:
Ages:
Business Phone:
New Business Phone:
If corporate transfer, employer:
Transfer Date:
Additional Information

SECTION 4:
BUYER INFORMATION
Preferred Area:
HomeSearch date:
Price Range:
Style:
Bedrooms:
Bathrooms:
Additional Information

SECTION 5:
LISTING INFORMATION
Address:
City:
Province:
Postal Code:
I, John Collins, hereby agree to pay a 30% referral of the referred function on a completion of the above transaction(s). John Collins will return a signed copy to you.