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60F, <br />h�O <br />1_ <br />q C <br />AGENCY DISCLOSURE STATEMENTPOR in <br />�@w'T of GO N <br />The real estate agent who is providing you with this form is required to do so by Ohio law. You will not be bound to pay the <br />agent or the agent's brokerage by merely signing this form. Instead, the purpose of this form is to confirm that you have been <br />advised of the role of the agent(s) in the transaction proposed below. (For purposes of this form, the term "seller" includes a landlord <br />and the term "buyer" includes a tenant.) <br />Property Address: 6488 White rd, Mayfield Village, OH 44143 <br />Buyer(s): Mayfield Village <br />Seller(s): FHLMC <br />1. TRANSACTION INVOLVING TWO AGENTS IN TWO DIFFERENT BROKERAGES <br />The buyer will be represented by, and <br />AGENT(S) BROKERAGE <br />The seller will be represented byand <br />AGENT(S) BROKERAGE <br />II. TRANSACTION INVOLVING TWO AGENTS IN THE SAME BROKERAGE <br />If two agents in the real estate brokerage <br />represent both the buyer and the seller, check the following relationship that will apply: <br />Agent(s), work(s) for the buyer and <br />Agent(s)work(s) for the seller. Unless personally <br />involved in the transaction, the principal broker and managers will be "dual agents," which is further explained on the back of this <br />form. As dual agents they will maintain a neutral position in the transaction and they will protect all parties' confidential <br />information. <br />■❑ <br />❑ Every agent in the brokerage represents every "client"' of the brokerage. Therefore, agents <br />and rill be working for both the buyer and seller as "dual agents." Dual agency is explained <br />on the back of this form. As dual agents they will maintain a neutral position in the transaction and they will protect all parties' <br />confidential information. Unless indicated below, neither the agent(s) nor the brokerage acting as a dual agent in this transaction <br />has a personal, family or business relationship with either the buyer or seller. If such a relationship does exist, explain: <br />M. TRANSACTION INVOLVING ONLY ONE REAL ESTATE AGENT <br />Agent(s) Paul Kleinhenz and real estate brokerage ERA Real Solutions will <br />❑ be "dual agents" representing both parties in this transaction in a neutral capacity. Dual agency is further explained on the back of <br />this form. As dual agents they will maintain a neutral position in the transaction and they will protect all parties' confidential <br />information. Unless indicated below, neither the agent(s) nor the brokerage acting as a dual agent in this transaction has a <br />personal, family or business relationship with either the buyer or seller. If such a relationship does exist, explain: <br />® represent only the (check one) ® seller or ❑ buyer in this transaction as a client. The other party is not represented and agrees to <br />represent his/her own best interest. Any infonnation provided the agent may be disclosed to the agent's client. <br />CONSENT <br />I (we) consent to the above relationships as we enter into this real estate transaction. If there is a dual agency in this transaction, I <br />(we) acknowledge reading the information regarding dual agency explained on the back of this form. <br />SELLER/LANDLORD A <br />Mayfield Village Brenda Bodnar Mayor <br />BUYER/TENANT DATE SELLER/LANDLORD <br />DATE <br />C; Page 1 of 2 Effective 02/1019 <br />