MA Agency Disclosure

BOARD OF REGISTRATION OF REAL ESTATE BROKERS AND SALESPERSONS

http://www.mass.gov/ocabr/licensee/dpl-boards/re/

MASSACHUSETTS MANDATORY LICENSEE-CONSUMER RELATIONSHIP DISCLOSURE

THIS IS NOT A CONTRACT

This disclosure is provided to you, the consumer, by the real estate licensee listed in this disclosure.

THE TIME WHEN THE LICENSEE MUST PROVIDE THIS NOTICE TO THE CONSUMER:

All real estate licensees must present this form to you at the first personal meeting with you to discuss a specific residential property. If

there is no personal meeting between you and the licensee, this form must be presented electronically or through some other means

before the licensee enters into a contract with a consumer. Residential property is defined as land with a building intended for use as a

one to four-unit residential dwelling or the purchase or sale of land on which a building is intended to be constructed for use as a one-or

two-unit residential dwelling. In the event this relationship changes an additional disclosure must be provided and completed at that time.

CONSUMER INFORMATION AND RESPONSIBILITY:

If you are a buyer or seller, you can engage a licensee to provide advice, assistance and representation to you as your agent. The

licensee can represent you as the seller (Seller's Agent) or represent you as the buyer (Buyer's Agent), or can assist you as a Facilitator.

All real estate licensees, regardless of the working relationship with a consumer must, by law, present properties honestly and

accurately, and disclose known material defects in the real estate.

The duties of a real estate licensee do not relieve consumers of the responsibility to protect their own interests. If you need advice for

legal, tax, insurance or land survey matters it is your responsibility to consult a professional in those areas. Real estate licensees do not

and cannot perform home, lead paint, or insect inspections, nor do they perform septic system, wetlands or environmental evaluations.

Do not assume that a real estate licensee works solely for you unless you have an agreement for that relationship.

For more detailed definitions and descriptions about real estate relationships, please see page 2 of this disclosure.

THE SELLER OR BUYER RECEIVING THIS DISCLOSURE IS HEREBY ADVISED THAT THE REAL

ESTATE LICENSEE NAMED BELOW IS WORKING AS A:

Check one: Seller's agent Buyer's agent Facilitator

If seller's or buyer's agent is checked above, the licensee must complete the following section:

Check one: Non-Designated Agency Designated Agency

The real estate firm or business listed below and all

other affiliated agents are also working as the agent

of the

Seller Buyer

Only the licensee named herein represents the

Seller Buyer (designated seller agency or designated

buyer agency). In this situation any other agents affiliated

with the firm or business listed below do not represent you

and may represent another party in your real estate

transaction.

By signing below, I, the real estate licensee, acknowledge that this disclosure has been provided to the consumer named herein:

Broker Salesperson

Signature of Licensee Printed Name of Licensee License # Today's Date

Name of Brokerage Firm Brokerage Firm License #

Buyer Seller

Signature of consumer Printed name of consumer Today's Date

Buyer Seller

Signature of consumer Printed name of consumer Today's Date

Check here if the consumer declines to sign this notice.

Last Revised September 20, 2021

Phone: Fax:

Produced with Lone Wolf Transactions (zipForm Edition) 717 N Harwood St, Suite 2200, Dallas, TX 75201 www.lwolf.com

Lisa Berry 9509196

Simply Sell Realty, 9 Cornerstone Sq Ste 400 #206 Westford MA 01886 9783150300 9783150300 MA

Lisa Berry

Simply Sell Realty 9509196