Agent Referral

Sheila Maddox

5252 Roswell Road,
Suite 202
Atlanta, Georgia 30342

Office 404-252-4908
Fax 404-250-5337

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Please complete the following so I can promptly respond to your request.

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Contact Information:
Your Name:	*	Company:	*
Email:	*	Phone #:	*
Is the client aware they are being referred? Yes No			*
Requested referral fee: *
Are you referring a buyer or a seller? Buyer Seller			*
Client information
Client's Name:	*	Home #:
Email:		Office #:
Address:		State/Zip:
City:		Preferred time to be contacted:
Preferred contact method: Email Home Office Mail
Property Information
Please provide the following information about the desired home purchase or property to be sold:
Bedrooms:	*	Baths:	*
Price Range	*	Area	*
Describe any other features/requirements:

Describe any preferences in neighborhood, amenities and schools:

How did you hear about me? *

Sheila Maddox
Licensed in the State of Georgia
Coldwell Banker Residential Brokerage
Owned And Operated by NRT LLC