State of New Hampshire


OFFICE OF PROFESSIONAL LICENSURE AND CERTIFICATION

DIVISION OF LICENSING AND BOARD ADMINISTRATION

7 Eagle Square, Concord, NH 03301-4980

Phone: 603-271-2152


BROKERAGE RELATIONSHIP DISCLOSURE FORM

(This is Not a Contract)

This form shall be presented to the consumer at the time of the first business meeting, prior to any discussion of confidential information.


Right Now, You Are a Customer

As a customer, the licensee with whom you are working is not obligated to keep confidential the information that you might share with him or her. As a customer, you should not reveal any confidential information that could harm your bargaining position.

To Become a Client

Clients receive more services than customers. You become a client by entering into a written contract for representation as a seller/landlord or as a buyer/tenant. As a customer, you can expect a real estate licensee to provide the following customer-level services:


Customer-Level Services

  • To disclose all material defects known by the licensee pertaining to the on-site physical condition of the real estate;

  • To treat both the buyer/tenant and seller/landlord honestly;

  • To provide reasonable care and skill;

  • To account for all monies received from or on behalf of the buyer/tenant or seller/landlord relating to the transaction;

  • To comply with all state and federal laws relating to real estate brokerage activity; and

  • To perform ministerial acts, such as showing property, preparing, and conveying offers, and providing information and administrative assistance.

Client-Level Services

  • Confidentiality

  • Loyalty

  • Disclosure

  • Lawful Obedience

  • Promotion of the client’s best interest


For seller/landlord clients:

The agent will put the seller/landlord’s interests first and work on behalf of the seller/landlord.

For buyer/tenant clients:

The agent will put the buyer/tenant’s interests first and work on behalf of the buyer/tenant.

Client-level services also include advice, counsel, and assistance in negotiations.

For important information about your choices in real estate relationships, please read on.


Acknowledgment

By continuing with our services, you acknowledge and consent to this Brokerage Relationship Disclosure Form, agreeing to the terms outlined herein. This acknowledgment is legally binding and serves as your signature.

By continuing with these services, I, Stephanie Lucas, acknowledge and consent to the terms of this Brokerage Relationship Disclosure Form as provided herein.

Provided by:

Name: Stephanie Lucas

License #: 070715

Brokerage Firm: Keller Williams Gateway Realty

Broker License #: 069316

To check on the license status of a real estate firm or licensee, use the licensee lookup at oplc.nh.gov. Inactive licensees may not practice real estate brokerage.


Types of Brokerage Relationships Commonly Practiced in New Hampshire

  • SELLER AGENCY (RSA 331-A:25-b)
    A seller agent acts on behalf of a seller or landlord in the sale, exchange, rental, or lease of real estate. The seller is the licensee’s client, and the licensee has the duty to represent the seller’s best interest.

  • BUYER AGENCY (RSA 331-A:25-c)
    A buyer agent acts on behalf of a buyer or tenant in the purchase, exchange, rental, or lease of real estate. The buyer is the licensee’s client, and the licensee has the duty to represent the buyer’s best interests.

  • SINGLE AGENCY (RSA 331-A:25-b; RSA 331-A:25-c)
    Single agency is a practice where a firm represents the buyer only, or the seller only, but never in the same transaction.

  • SUB-AGENCY (RSA 331-A:2, XIII)
    A sub-agent works for one firm but is engaged by the principal broker of another firm to perform agency functions on behalf of the principal broker’s client.

  • DISCLOSED DUAL AGENCY (RSA 331-A:25-d)
    A disclosed dual agent acts for both the seller/landlord and the buyer/tenant in the same transaction with knowledge and written consent from all parties.

  • DESIGNATED AGENCY (RSA 331-A:25-e)
    A designated agent represents one party in a real estate transaction and owes that party client-level services.

  • FACILITATOR (RSA 331-A:25-f)
    A facilitator assists one or more parties during all or a portion of a real estate transaction without being an agent or advocate.

  • ANOTHER RELATIONSHIP (RSA 331-A:25-a)
    If another relationship is intended, it must be described in writing and signed by all parties prior to services being rendered.