This form contains 50 fields organized into 20 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Acknowledgement Date
Acknowledgement Day Text
Provide the day of the month for the date of acknowledgement.
Max length: 60 characters
Acknowledgement Month Text
Provide the month number for the date of acknowledgement.
Max length: 18 characters
Acknowledgement Year Number
Provide the year for the date of acknowledgement.
Max length: 22 characters
Agreement Commencement
Commencement Month Text
Please provide the month when the agreement commences.
Max length: 69 characters
Commencement Day Text
Please provide the day of the month when the agreement commences.
Max length: 20 characters
Commencement Time Time
Please provide the specific time when the agreement commences.
Max length: 23 characters
Commencement Year Text
Please provide the last two digits of the year when the agreement commences.
Max length: 14 characters
Agreement Expiry
Expiry Month Text
Please enter the month on which the agreement expires.
Max length: 69 characters
Expiry Day Text
Please enter the day of the month on which the agreement expires.
Max length: 20 characters
Expiry Year (last two digits) Text
Please enter the last two digits of the year on which the agreement expires.
Max length: 14 characters
Brokerage Agreement Details
Brokerage Representative Name Text
Provide the name of the person authorized to bind the Brokerage.
Max length: 47 characters
Agreement Date Date
Enter the date when the agreement was signed. Fill only if 'Brokerage Representative Name' is filled.
Max length: 25 characters
Depends on: Brokerage Representative Name
Signer's Name Text
Provide the name of the individual signing this agreement. Fill only if 'Brokerage Representative Name' is filled.
Max length: 37 characters
Depends on: Brokerage Representative Name
Brokerage Information
Brokerage Name Text
Enter the legal name of the real estate brokerage.
Max length: 138 characters
Brokerage Address Line 1 Text
Provide the primary street address for the brokerage.
Max length: 163 characters
Brokerage Address Line 2 Text
Provide additional address details for the brokerage, such as apartment number, suite, or unit.
Max length: 85 characters
Brokerage Fax Number Text
Enter the fax number for the brokerage.
Max length: 35 characters
Brokerage Telephone Number Text
Enter the primary telephone number for the brokerage.
Max length: 34 characters
Brokerage Initials
Brokerage Initial Text
Enter the initials of the brokerage representative.
Max length: 10 characters
Buyer Information
Buyer Name Text
Please enter the full legal name of the buyer.
Max length: 150 characters
Buyer Street Address Text
Please enter the complete street address including street number and street name for the buyer.
Max length: 164 characters
Buyer Municipality Text
Please enter the municipality where the buyer's address is located.
Max length: 87 characters
Buyer Postal Code Text
Please enter the postal code for the buyer's address.
Max length: 44 characters
Buyer Warranty Initial
Buyer's Initials Text
Please provide the buyer's initials to acknowledge the warranty statement.
Max length: 10 characters
Buyer(s) Initials
Buyer Initials Text
Provide the initials of the buyer(s) to acknowledge this section of the agreement.
Max length: 10 characters
Commission Details
Commission Percentage Number
Enter the percentage of the sale price of the property that the Brokerage is entitled to receive as commission. Fill only if 'Property Type (Use)' is 'Purchase'.
Max length: 40 characters
Depends on: Property Type
Fixed Commission Amount (Purchase) Number
Enter the fixed dollar amount of commission the Brokerage is entitled to receive for a property purchase. Fill only if 'Property Type (Use)' is 'Purchase'.
Max length: 168 characters
Depends on: Property Type
Commission for Lease Number
Enter the commission amount the Brokerage is entitled to receive for a lease agreement. Fill only if 'Property Type (Use)' is 'Lease'.
Max length: 135 characters
Depends on: Property Type
Declaration of Insurance
Salesperson/Broker/Broker of Record Name Text
Provide the full name of the Salesperson, Broker, or Broker of Record.
Max length: 80 characters
Signature of Salesperson/Broker/Broker of Record Text
Provide the signature of the Salesperson, Broker, or Broker of Record. Fill only if 'Salesperson/Broker/Broker of Record Name' is filled.
Max length: 95 characters
Depends on: Salesperson/Broker/Broker of Record Name
First Buyer Acknowledgement Signature
Acknowledgement Day Text
Enter the day of the month when the buyer(s) acknowledged the agreement.
Max length: 80 characters
Acknowledgement Year Date
Enter the last two digits of the year when the buyer(s) acknowledged the agreement. Fill only if 'Acknowledgement Day' is filled.
Max length: 35 characters
Depends on: Acknowledgement Day
First Buyer Signature Details
Buyer Signature Text
Please provide the full legal signature of the first buyer.
Max length: 51 characters
Buyer Telephone Number Text
Please enter the telephone number of the first buyer. Fill only if 'Buyer Signature' is filled.
Max length: 33 characters
Depends on: Buyer Signature
Signature Date Date
Please enter the date when the first buyer signed the agreement. Fill only if 'Buyer Signature' is filled.
Max length: 22 characters
Depends on: Buyer Signature
Page 2
Brokerage Initials Text
Please provide the initials of the brokerage.
Max length: 11 characters
Buyer Initials Text
Please provide the initials of the buyer(s).
Max length: 7 characters
Page 4
Brokerage Initials Text
Enter the initials of the brokerage representative. Fill only if 'Brokerage Name' is specified as a party to the agreement.
Max length: 7 characters
Depends on: Brokerage Name
Buyer Initials Text
Enter the initials of the buyer(s). Fill only if 'Buyer Name' is specified as a party to the agreement.
Max length: 7 characters
Depends on: Buyer Name
Brokerage Name Text
Enter the full legal name of the brokerage. Fill only if 'BROKERAGE' is filled
Max length: 102 characters
Depends on: Brokerage Name
Buyer Name Text
Enter the full legal name of the buyer(s). Fill only if 'BUYER' is filled
Max length: 112 characters
Depends on: Buyer Name
Property Description
Property Type Text
Please provide a description of the type of property or its intended use.
Max length: 56 characters
Geographic Location Text
Please provide the geographic location of the property being sought.
Max length: 55 characters
Schedule A
Number of Schedule A Forms Text
Please enter the total number of Schedule A forms that are attached and form part of this Agreement.
Max length: 54 characters
Second Buyer Acknowledgement Signature
Second Buyer Signature Text
Please provide the signature of the second buyer to acknowledge understanding and receipt of the agreement. Fill only if 'Second Buyer Signature' is filled.
Max length: 80 characters
Depends on: Second Buyer Signature
Second Buyer Signature Date Date
Please enter the date when the second buyer signed the acknowledgement. Fill only if 'Second Buyer Signature' is filled.
Max length: 35 characters
Depends on: Second Buyer Signature
Second Buyer Signature Details
Second Buyer Signature Text
Please enter the signature of the second buyer. Fill only if 'Buyer Signature' there is a second buyer.
Max length: 51 characters
Depends on: Buyer Signature
Second Buyer Telephone Number Text
Please enter the telephone number of the second buyer. Fill only if 'Second Buyer Signature' is filled.
Max length: 33 characters
Depends on: Second Buyer Signature
Second Buyer Signature Date Date
Please provide the date when the second buyer signed the document. Fill only if 'Second Buyer Signature' is filled.
Max length: 22 characters
Depends on: Second Buyer Signature
Time Period Acknowledgement Initial
Buyer's Initials Text
Please provide the Buyer's initials to acknowledge the time period for this agreement.
Max length: 10 characters