Approved Nevada Real Estate Division
Page 1 of 1
Replaces all previous editions
CONSENT TO ACT
This form does not constitute a contract for services nor an agreement to pay compensation.
DESCRIPTION OF TRANSACTION: The real estate transaction is the sale and purchase or lease of
In Nevada, a real estate licensee may act for more than one party in a real estate transaction; however, before the licensee
does so, he or she must obtain the written consent of each party. This form is that consent. Before you consent to having
a licensee represent both yourself and the other party, you should read this form and understand it.
Licensee: The licensee in this real estate transaction is
license number is
and who is affiliated with
CONFLICT OF INTEREST: A licensee in a real estate transaction may legally act for two or more parties who have
interests adverse to each other. In acting for these parties, the licensee has a conflict of interest.
DISCLOSURE OF CONFIDENTIAL INFORMATION: Licensee will not disclose any confidential information for
one year after the revocation or termination of any brokerage agreement entered into with a party to this transaction,
unless Licensee is required to do so by a court of competent jurisdiction or is given written permission to do so by that
party. Confidential information includes, but is not limited to, the client’s motivation to purchase, trade or sell, which if
disclosed, could harm one party’s bargaining position or benefit the other.
DUTIES OF LICENSEE: Licensee shall provide you with a “Duties Owed by a Nevada Real Estate Licensee”
disclosure form which lists the duties a licensee owes to all parties of a real estate trans