Form AD, Disclosure Regarding Real Estate Agency Relationship Instructions

Check this box if more than one agent from the same real estate firm represents the buyer and an Additional Agent Acknowledgement (C.A.R. Form AAA) is attached.

Provide a textual indication regarding the status or reference of additional buyer preferences and priorities.

Enter initials or any required acknowledgment for the attached Buyer Identification of Preferences and Priorities form.

Please provide the first line of any additional description for the property.

Please provide the second line of any additional description for the property.

Please provide the third line of any additional description for the property.

Check this box if an Additional Signature Addendum (C.A.R. Form ASA) is attached to this document.

Check this box if there are other advisories, addenda, or disclosures attached that are not specifically listed. Fill only if 'Properties Excluded from Representation' has an attached list

Provide the name or a brief description of any additional advisories, addenda, or disclosures attached. Fill only if 'Other' is 'Yes'.

Enter the full legal name of the agent.

Provide the Department of Real Estate (DRE) license number for the agent.

Enter the full legal name of the salesperson or broker-associate.

Provide the Department of Real Estate (DRE) license number for the salesperson or broker-associate.

Enter the date this form or section was completed.

Enter the first alternative fixed dollar amount for compensation.

Enter the second alternative fixed dollar amount for compensation.

Enter the third alternative fixed dollar amount for compensation. Fill only if 'Alternative Fixed Compensation Option 2' is 'Yes'.

Enter the percentage of the acquisition price that will be paid as compensation. Fill only if 'Alternative Fixed Compensation Option 1' is 'Yes'.

Enter the fixed dollar amount of compensation to be paid, if applicable, in addition to the percentage of the acquisition price. Fill only if 'Alternative Fixed Compensation Option 1' is 'Yes'.

Enter the percentage of the acquisition price to be paid as compensation.

Enter the initials of the primary broker or agent.

Enter the initials of the secondary broker or agent, if applicable.

Enter the alternative number of calendar days to deliver Buyer personal/financial information if different from the default of 5 days.

Indicate if the C.A.R. Form BFPI is attached to this agreement.

Enter 'Yes' if the Buyer does not have sufficient funds to pay the Broker, or 'No' if they do. Fill only if 'CAR Form BFPI Attached Indication' is 'Yes'.

Provide any additional confirming text or initials regarding the Buyer's funds status, especially if indicating insufficient funds.

Enter the first set of initials for the buyer. Fill only if 'Exclusive' is 'Yes'.

Enter the second set of initials for the buyer. Fill only if 'Exclusive' is 'Yes'.

Enter the first set of initials for the broker or agent. Fill only if 'Exclusive' is 'Yes'.

Enter the second set of initials for the broker or agent. Fill only if 'Exclusive' is 'Yes'.

Please provide the license number of the buyer's agent.

Enter the legal name of the buyer's brokerage firm. Fill only if 'Broker is representing both the buyer and seller' is 'Yes'.

Enter the Department of Real Estate (DRE) license number for the buyer's brokerage firm. Fill only if 'Buyer's Brokerage Firm Name' is filled.

Enter the full name of the individual acting as the buyer's representative. Fill only if 'Buyer's Brokerage Firm Name' is filled.

Enter the Department of Real Estate (DRE) license number for the individual buyer's representative. Fill only if 'Buyer's Representative Name' is filled.

Provide the date the buyer's representative signed this document. Fill only if 'Buyer's Representative Name' is filled.

Enter the license number for the buyer's brokerage firm.

Check this box if the buyer's brokerage firm represents only the buyer in this transaction.

Enter the buyer's initials for the first designated area.

Enter the buyer's initials for the second designated area.

Provide the initials of the first buyer. Fill only if 'Exclusive representation' is 'Yes'.

Provide the initials of the second buyer, if applicable. Fill only if 'Exclusive representation' is 'Yes'.

Enter the number of days after receipt for the non-exclusive cancellation to become effective.

Enter the number of days after receipt for the exclusive cancellation to become effective.

Enter the maximum number of days for the exclusive cancellation period. Fill only if 'Exclusive Cancellation Effective Days' is 'Yes'.

Enter the number of calendar days for the continuation period following the representation period.

Enter the number of days for any extension to the continuation period. Fill only if 'Continuation Period Calendar Days' is 'Yes'.

Provide the full legal name of the entity. If it is a trust, enter the complete trust name; if it is under probate, enter the full name of the estate, including its case number.

Enter the full name of the first broker or agent signing the document.

Enter the date the first broker or agent signs the document.

Enter the telephone number for the first broker or agent.

Enter the email address for the first broker or agent.

Enter the DRE License number for the first broker or agent.

Enter the date the buyer signed this document.

Provide the full printed name of the buyer.

Check this box if the printed name provided for the first buyer signature is that of a legally authorized signer acting in a representative capacity.

Enter the title of the buyer, if applicable. Fill only if 'Printed Name of Legally Authorized Signer' is filled and the signer has a title.

Please enter the printed name of the first buyer. Fill only if 'Broker is representing both the buyer and seller' is 'Yes'.

Please provide the date the first buyer signed. Fill only if 'First Buyer Printed Name' is filled.

Enter the full name or signature of the first seller. Fill only if 'Broker is representing both the buyer and seller' is 'Yes'.

Enter the date the first seller signed. Fill only if 'First Seller Signature' is filled.

Check this box if the first signatory is a Buyer.

Check this box if the first signatory is a Seller.

Check this box if the first signatory is a Landlord.

Check this box if the first signatory is a Tenant.

Please provide the full name of the first signatory acknowledging receipt of this disclosure.

Please enter the date when the first signatory acknowledged receipt of this disclosure.

Please provide the full name of the first legally authorized signer.

Please provide the full name of the second legally authorized signer.

Please provide the full name of the first buyer.

Please provide the date when the first buyer signed. Fill only if 'Buyer 1 Name' is signed.

Please provide the full name of the second buyer.

Please provide the date when the second buyer signed. Fill only if 'Buyer 2 Name' is signed.

Please enter the first additional term or condition not specified elsewhere in this agreement.

Please enter the second additional term or condition not specified elsewhere in this agreement. Fill only if is 'Yes'.

Enter the date when the first Seller or Buyer acknowledged the receipt and understanding of the Broker Compensation Advisory. Fill only if is filled.

Enter the full name of the second Seller or Buyer who is acknowledging the receipt and understanding of the Broker Compensation Advisory. Fill only if 'second Printed name of Buyer' is filled.

Enter the date when the second Seller or Buyer acknowledged the receipt and understanding of the Broker Compensation Advisory. Fill only if 'Seller/Buyer Name (2)' is filled.

Enter the full name of the first party acknowledging receipt of the advisory.

Enter the date the first party acknowledged receipt of the advisory.

Enter the full name of the second party acknowledging receipt of the advisory.

Enter the date the second party acknowledged receipt of the advisory.

Enter the first amount received by the broker from the seller or others.

Enter the second amount received by the broker from the seller or others.

Enter the third amount received by the broker from the seller or others.

Please provide the date when this document was prepared.

Enter the paragraph number that specifies the properties excluded from representation.

Provide a detailed description of the properties that are excluded from representation.

Enter any reference or confirmation if the excluded properties are identified on an attached list. Fill only if 'Paragraph Number Excluded Properties' is 'Yes'.

Provide a detailed list of specific property locations, addresses, or areas of interest for property acquisition.

Enter a general description of the geographic area or primary location where the buyer intends to acquire property.

Check this box if the property location is restricted to specific county or counties.

Check this box if the property location is restricted to specific city or cities.

List the names of the counties where the buyer intends to acquire property.

List the names of the cities where the buyer intends to acquire property.

Provide a detailed description of the specific properties to be acquired, if not covered by the predefined categories.

Specify the general type of property to be acquired.

Provide additional details or another general property type for the property to be acquired.

Enter the first specific property type if narrowing down from general types.

Enter the second specific property type if narrowing down from general types.

Enter the third specific property type if narrowing down from general types.

Enter the full legal name of the real estate broker firm.

Provide the Department of Real Estate (DRE) license number for the real estate broker firm.

Enter the street address for the real estate broker firm.

Enter the city for the real estate broker firm's address.

Enter the state for the real estate broker firm's address.

Enter the zip code for the real estate broker firm's address.

Provide the date when this representation period begins.

Provide the date when this representation period ends.

Enter the header text for the paragraph number column.

Enter the header text for the paragraph title or contract term column.

Enter the header text for the terms and conditions column.

Please provide the full name of the party being represented.

Enter the telephone number for the first broker or agent.

Enter the date when the second broker or agent signed this document.

Enter the telephone number for the second broker or agent.

Enter the email address for the first broker or agent.

Enter the email address for the second broker or agent.

Please provide the date when the second buyer signed the document.

Please provide the printed full name of the second buyer.

Check this box if the printed name for the second buyer's signature is that of a legally authorized signer acting in a representative capacity, rather than as an individual.

Please provide the title of the second buyer, if applicable. Fill only if 'Printed Name of Legally Authorized Signer' is filled and the signer has a title.

Enter the full printed name of the second buyer. Fill only if 'First Buyer Printed Name' is filled.

Enter the date the second buyer signed. Fill only if 'Second Buyer Printed Name' is filled.

Please provide the second seller's signature or name. Fill only if 'First Seller Signature' is filled.

Please provide the date the second seller signed. Fill only if 'Second Seller Signature' is filled.

Check this box if the second signatory is the Buyer.

Check this box if the second signatory is the Seller.

Check this box if the second signatory is the Landlord.

Check this box if the second signatory is the Tenant.

Enter the name of the real estate broker firm for the second signatory.

Enter the date the second real estate broker firm signed the disclosure.

Enter the license number of the seller's agent.

Enter the full legal name of the seller's brokerage firm. Fill only if 'Broker is representing both the buyer and seller' is 'Yes'.

Enter the Department of Real Estate (DRE) license number for the seller's brokerage firm. Fill only if 'Seller's Brokerage Firm Name' is filled.

Enter the name of the individual representative signing on behalf of the seller's brokerage firm. Fill only if 'Seller's Brokerage Firm Name' is filled.

Enter the Department of Real Estate (DRE) license number for the individual representative of the seller's brokerage firm. Fill only if 'Seller's Brokerage Firm Representative Name' is filled.

Enter the date the individual representative signed this document. Fill only if 'Seller's Brokerage Firm Representative Name' is filled.

Please provide the license number for the Seller's Brokerage Firm.

Check this box if the Seller's Brokerage Firm is acting as the broker for the seller only.

Provide the paragraph reference number or identifier related to the type of representation being specified.

Indicate whether the representation is 'Non-exclusive' or 'Exclusive'. 'Exclusive' is only valid if checked and initialed in paragraph 15.