AUTHORITY TO SELL

is hereby given to:

By virtue of my fiduciary trust, and in consideration of your acceptance of my offer, I hereby give
you ninety (90) days from this date, _______________, the Authority to offer my Property for Sale with a
commission of three (3) % of the selling price of my property described below at the price and following
conditions:

TITLE NUMBER: ___________________________________________________________

LOT AND/OR FLOOR AREA: ___________Square Meters/_____________Square Meters
LOCATION: _______________________________________________________________
OTHER PERTINENT DESCRIPTION:
_____________________________________________________________________________________
_____________________________________________________________________________________
OFFER PRICE: ________________________________
TERMS OF PAYMENT: _________________________________________________________
REMARKS:__________________________________________________________________________
____________________________________________________________________________________

Should the sale be made or effected on modified terms or such other terms as may be accepted by me,
you are likewise credited for the said sale and shall be given the above mentioned commission based on
the revised/agreed price.

Notwithstanding the expiration of this authority to sell, you shall still be entitled to your full
commission provided that the name of the prospective buyer has been registered with me in writing
during the period of your authority.

___________________________________
SELLER (Signature over Printed Name)

TAXPAYER IDENTIFICATION NUMBER: _____________________________

RESIDENCE CERTIFICATE NO: ____________________
ISSUED AT: ______________________________________
DATE OF ISSUE: __________________________________

___________________________________
SPOUSE OF SELLER (Signature over Printed Name)

TAXPAYER IDENTIFICATION NUMBER: _____________________________

RESIDENCE CERTIFICATE NO: ____________________
ISSUED AT: ______________________________________
DATE OF ISSUE: __________________________________