Birdy Properties

Agent Referral Form
Receiving Office

Real Estate Office:	Birdy Properties
Street:	15203 Spring Water Circle
City:	San Antonio
St./Prov.:	Texas
Zip:	78247
Phone:	(210) 490-98888
Fax:	(210) (210) 490-9895

Referring Office
Real Estate Company:
Referring Office Federal ID# :
Associate:
Associate S.S. of SIN#:
Street:
City:
St/Prov:
Zip:
Phone:

Client Information
Name:
Address:
City:
St/Prov:
Zip:
Home Phone:
Employer:
Business Phone:
Address of property being referred (if different from above):

Comments:

Status of present home (if applicable):
Currently Listed at:
Not yet listed, will sell for:
Sold at:
Equity:
Currently Listed at:
Must client sell first?	yes no
Reason for move:	transfer new job other
Move definite:	yes no

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Agent Referral Form