RENTED INFORMATION FORM
Please fill out the following form.
 
PROPERTY ADDRESS
MLS #:
(If your property has more than one MLS #, then separate by comma)
 
Street Address:
Town:
State:              Zip Code:
 
 
RENTED  INFORMATION
Rental Date: ,
Rental Price:
Tenant’s Financing: (choose 1)
Cash      Owner Finance      Other
Tenant’s Agent Name (if none, write “NB112114”):
Tenant’s Agent Office Name (if none, write “EntryOnly”):
Commission Paid:
Maine and New Hampshire properties are required to fill out the following information:
Tenant's Name:                Tenant's Zip Code:

The Landlord hereby authorizes the Broker to change the status of the aforementioned property listed in the Multiple Listing Service through which said listing is currently being distributed.
Landlord 1 Name Landlord 2 Name (if applicable)
 
Typing your name shall be considered your Electronic Signature and is as binding as a handwritten signature.
The Uniform Electronic Transactions Act (UETA) - Section 7 (d) states "If a law requires a signature, an electronic signature satisfies the law."
 
Landlord 1 Email Address Landlord 2 Email Address (if applicable)
Must be a valid email address or form will not be submitted
(You will be sent a copy of the information to the emails provided)

READ THIS CAREFULLY: If there is more than one “Seller” of the Property, (1) each such Seller must sign this Form for it to be effective and (2) references in the Form to a single “Seller” will be deemed to refer to each of the Sellers.