COLDWELL BANKER GUNDAKER
OUTGOING REFERRAL FORM
Please use for placing referrals outside of your local service area
Phone: 800-417-6270 Fax: 781-609-1946 Email:
DATE: / NAME: / BRANCH/SALES OFFICE:OFFICE #: / HOME #: / CELL #:
EMAIL ADDRESS: / Routine contact with you will be via email.
Please have Assigned Agent call me before contacting Customer: / Please just send me Key Updates:
Client NAME: /
Spouse/Partner:
HOME #:
/OFFICE #:
/CELL #:
Current Address:
/Email:
Best time to contact:
/ Morning / Afternoon / Evening /Employer
I have asked the customer’s permission to refer them. NO REFERRAL PLACED WITHOUT IT!
/ Yes: No:Listing Referral: / Is this property currently listed? / Yes: No: / With Whom?
ADDRESS: / CITY/STATE: / ZIP:
Home Style (SFH, condo, land, etc): / # Bed Rms: / # Baths:
Buyer Referral:
DESTINATION CITY AND STATE:
Reason for Real Estate Need (2nd home, job transfer, family, etc.):
PRICE RANGE (important): / Type of Housing Desired:
# Bed Rms: / # Baths: / # Garage: / # Children: / Ages:
Date Of Move: / Househunting Date: / School Needs:
Present Home:
Listed: / $ / Sold: / $ / Closing Date: / Rent:
Special Instructions:
**If you have already selected an agent to work with this client, please fill out the information below:
Agent Name: Broker: Office Ph #: Cell#: Email:
***REQUIRED FIELDS ARE IN BOLD PRINT***
Remember the more information we have the better job we can do for you!
Thank you.
Revised 04/13/09