Massachusetts Board of Registration of Real Estate Brokers and Salespersons
MANDATORY AGENCY DISCLOSURE - AGENCY RELATIONSHIP
The purpose of this disclosure is to enable you to make informed choices before working with a real estate licensee. It must be provided at the first personal meeting that you have with an agent to discuss a specific property. THIS IS NOT A CONTRACT. It is a disclosure notice for your information and protection. BE SURE TO READ THE DESCRIPTIONS OF THE DIFFERENT TYPES OF AGENCY REPRESENTATION ON THE OTHER SIDE OF THIS DISCLOSURE.
CONSUMER INFORMATION
CONSUMER RESPONSIBILITY
The duties of a real estate licensee do not relieve the consumer of the responsibility to protect his/her own interest. Consumers with questions on whether and how real estate agents share fees should pose them to the agent. If you need advice for legal, tax, insurance or other matters it is your responsibility to consult a professional in those areas.
ACKNOWLEDGEMENT
I have provided this disclosure form to ________________________________
(print name of consumer)
I will be assisting the above named consumer as a: (check one)
__ Seller's Agent __ Buyer's Agent
_____________________________ ________________ _______ 20___
(Signature of Real Estate Agent) (License Number) (Month, Day) (Year)
I have read this agency disclosure form IN ITS ENTIRETY ON BOTH SIDES. I understand that this form is for agency disclosure AND NOT A CONTRACT. It was provided to me by the agent named above.
_____________________________ _______ 20___
(Name of Consumer) (Month, Day) (Year)
Check Here: __ Buyer __ Seller
As a consumer I recognize that I need not select any agency representation at this time. Therefore, I decline to sign this disclosure. Any additional reason for declining to sign:
_____________________________________________
(print name of consumer and reason, if any)