NEW HAMPSHIRE REAL ESTATE COMMISSION
61 South Spring St., Concord, NH 03301 Tel.: (603) 271-2701
BROKERAGE RELATIONSHIP DISCLOSURE FORM
(This is Not a Contract)
This form shall be presented to the consumer at the time of first business meeting,
prior to any discussion of confidential information
not assume that a licensee
You Are A
Unless or until you enter into a written agreement for agency representation, you are
considered a Customer and the real estate broker or salesperson will not act as your
agent. As a Customer, you should not expect the real estate broker or salesperson to
promote your best interest, or to keep your bargaining information confidential.
Clients receive more services than customers. You become a client by entering into a written
agency agreement for representation as a seller/landlord or as a buyer/tenant.
In accordance with RSA 331-A:25-a the duties of an agent to a client are:
Client-level services also include advice, counsel and assistance in negotiations.
If you do not sign a written agency agreement, you will not be owed these duties.
To check on the license status of a real estate firm or licensee go to www.nh.gov/nhrec. Inactive licensees may not practice real estate brokerage.
(Page 1 of 2)
For more information about your choices in real estate relationships, please see page 2 of this disclosure form.
I acknowledge receipt of this disclosure as required by the New Hampshire Real Estate Commission (Pursuant
to Rea 701.01).
***** I understand that unless I have become a client I should
not disclose any confidential information *****