A. Upon having a substantive discussion about a specific property or properties in a residential real estate transaction with an actual or prospective buyer or seller who is not the client of the licensee and who is not represented by another licensee, a licensee shall disclose any broker relationship the licensee has with another party to the transaction. Further, except as provided in § 54.1-2139 or 54.1-2139.1, such disclosure shall be made in writing at the earliest practical time, but in no event later than the time when specific real estate assistance is first provided. Such disclosure may be given in combination with other disclosures or provided with other information, but if so, the disclosure must be conspicuous, printed in bold lettering, all capitals, underlined, or within a separate box. Any disclosure which complies substantially in effect with the following shall be deemed in compliance with this disclosure requirement: DISCLOSURE OF BROKERAGE RELATIONSHIP IN A RESIDENTIAL REAL ESTATE TRANSACTION
The undersigned do hereby acknowledge disclosure that:
The licensee...................... (name of broker or salesperson) associated with..........................(Name of Brokerage Firm) represents the following party in a residential real estate transaction:
..... Seller(s) or ..... Buyer(s)
..... Landlord(s) or ..... Tenant(s)
................. ...........................
Date Name
................. ...........................
Date Name