Fillable NOTICE OF NO AGENCY RELATIONSHIP

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NOTICE OF NO AGENCY RELATIONSHIP

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FORM 350 (6/14/13) COPYRIGHT ILLINOIS ASSOCIATION OF REALTORS® 1/1
ILLINOIS ASSOCIATION OF REALTORS®
NOTICE OF NO AGENCY RELATIONSHIP
Name of Licensee: _________________________________________________________________
Name of Sponsoring Brokerage Company__________________________________________________
Property Address___________________________________________________________________
NOTICE OF NO AGENCY RELATIONSHIP
(Check here if you represent either seller or buyer)
Thank you for giving Licensee the opportunity to (Insert description of work, i.e. showing property of a FSBO)
________________________________________________________________________________
in regard to the above mentioned property.
Licensee’s Sponsoring Broker has previously entered into an agreement with a client to provide certain
real estate brokerage services through Licensee who acts as that client's designated agent.
As a result, Licensee will not be acting as your agent.
THIS NOTICE OF NO AGENCY IS BEING PROVIDED AS REQUIRED BY STATE LAW.
_________________________________ Date__________________________
Licensee’s Signature
_________________________________
Print Customer’s Name (OPTIONAL)
_________________________________ Date__________________________
Customer Signature (OPTIONAL)
_________________________________
Print Customer’s Name (OPTIONAL)
_________________________________ Date__________________________
Customer Signature (OPTIONAL)
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NOTICE OF NO AGENCY RELATIONSHIP

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Completed 8 January 2021

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