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CONNECTICUT MANDATORY DISCLOSURE OF REAL ESTATE AGENCY RELATIONSHIPS

This disclosure is provided to you, the consumer, by the real estate agent listed on this form. Make sure you read both pages of this form. Page two
contains a more detailed description of the different types of relationships available to you. THIS IS NOT A CONTRACT. The purpose of this
disclosure is to enable you to make informed choices before working with a real estate agent. It is a disclosure notice for your information and
protection.

THE TIME WHEN THE REAL ESTATE AGENT MUST PROVIDE THIS NOTICE TO THE CONSUMER:
All real estate agents must present this form to you at the first personal meeting with you to discuss a specific property. The agent can represent you
as the seller/landlord (Listing Agent) or represent you as the buyer/tenant (Buyer/Tenant's Agent) and can also assist in the capacity of representing
both the seller and buyer or landlord and tenant (Dual Agency).

CONSUMER INFORMATION AND RESPONSIBILITY:

Whether you are the seller/landlord or buyer/tenant you can chose to have the advice, assistance and representation of your own agent who works for
you. Do not assume that a real estate agent works solely for you unless you have an agreement for that relationship. With your consent, real
estate agents from the same firm may represent a seller/landlord and buyer/tenant in the same transaction. These agents are referred to as dual agents.

The duties of a real estate agent do not relieve the consumer of the responsibility to protect his/her own interests. If you need advice for legal, tax,
insurance, land survey or other matters, it is your responsibility to consult a professional in those areas. Real estate agents do not have a duty to
perform home, lead paint or insect inspections nor do they perform septic system, wetlands or environmental evaluations.

ACKNOWLEDGEMENT

By signing below I, the real estate agent, acknowledge that this disclosure has been provided timely to the consumer named herein.

Diana Newbert 07/27/2019

(Signature of real estate agent) (Printed name of real estate agent) (Today's Date)

By signing below I, the consumer, acknowledge that I have received and read the information in this disclosure. I understand that I
should not provide any personal, financial or confidential information to the real estate agent until I have entered into either a
listing agreement and/or a buyer/tenant representation agreement with the company. I understand that this document has been
provided to me for the purposes of agency disclosure AND IS NOT A CONTRACT.

(Signature of consumer) (Printed name of consumer) (Today's Date)

(Signature of consumer) (Printed name of consumer) (Today's Date)

Check here if the consumer declines to sign this notice.

AGDISC Page 1 of 2

William Raveis Real Estate - New Milford, 69 Bank St. New Milford CT 06776
Phone: 860-354-3906 Fax: 860-210-2263 Diana Newbert Sartoris Guzzo
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TYPES OF AGENCY REPRESENTATION THAT WILLIAM RAVEIS REAL ESTATE OFFERS:

William Raveis Real Estate offers three possible types of agency relationships:
Seller/Landlord's Agent (Listing Agent)
Buyer/Tenant's Agent
Dual Agency (Including Single Agent)

William Raveis Real Estate is a Seller/Landlord's Agent (Listing Agent) and represents the seller/landlord when we list the owner's
home for sale and/or for rent. We are referred to as the Buyer/Tenant's Agent when we represent the buyer or tenant. When the
seller/buyer or landlord/tenant grants permission, we can represent both parties. This is referred to as Dual Agency.

Each agency relationship carries with it legal duties and responsibilities on the part of William Raveis Real Estate, the sales agent, as
well as the seller/landlord and buyer/tenant.

SELLER/LANDLORD'S AGENT (LISTING AGENT)

A Seller/Landlord's Agent (Listing Agent) acts solely in the best interest of their seller/landlord. A Listing Agent has fiduciary*
duties to the seller/landlord that include reasonable care, obedience, accounting, loyalty, confidentiality and full disclosure.

Although a Listing Agent does not represent the buyer, a Listing Agent must treat buyers honestly and fairly. A Listing Agent must
also disclose any and all material facts about the listed property that are known to the agent.

BUYER/TENANT'S AGENT
A Buyer/Tenant's Agent acts solely in the best interest of their buyer/tenant. A Buyer/Tenant's Agent has fiduciary* duties to the
buyer/tenant that include reasonable care, obedience, accounting, loyalty, confidentiality and full disclosure. A Buyer/Tenant's Agent
must act honestly and fairly with all parties to the transaction.

DUAL AGENCY
Dual Agency is a relationship in which William Raveis Real Estate (the Company) does not represent either the seller/landlord or the
buyer/tenant exclusively. All the sales agents for the Company act in a fiduciary* capacity for both the seller/landlord and
buyer/tenant. In order for the Company and its sales agents to represent sellers/landlords and buyers/tenants in a Dual Agency
relationship, both the buyer and seller (or landlord and tenant) must first consent in writing.

The Company and the sales agents may not disclose to either the seller/landlord or buyer/tenant any personal, financial or confidential
information about the other party except as authorized in writing by the respective party or as required by law.

The Company and its sales agents may not disclose, unless otherwise instructed by the respective party:

to buyer/tenant that the seller/landlord will accept less than asking or listing price

to the seller/landlord that the buyer/tenant can pay a price greater than the price submitted in a written offer

that the buyer or seller will agree to financing terms other than those offers

Dual Agency occurs when a sales agent for the Company has a buyer/tenant client who wants to preview a property listed by another
sales agent with the Company.

Dual Agency/Single Agent occurs when a sales agent for the Company has a buyer/tenant client who wants to preview a property that
is listed by the same sales agent.

*A relationship of trust and confidence, as between trustee and beneficiary, attorney and client, or principal and agent.

AGDISC Page 2 of 2

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EXCLUSIVE RIGHT TO REPRESENT BUYER AUTHORIZATION

I. Exclusive Right Appointment

A. You, Buyer(s) Jeanine Marie Sartoris, Carolanne Guzzo
appoint Us
William Raveis Real Estate, Inc. as Your exclusive real estate Broker to represent You and assist You in locating and
purchasing or exchange real property acceptable to You and generally described as residential real estate located within the
State of Connecticut (the "Property"). During the term of this Authorization You will work exclusively through Us in
locating and purchasing or exchanging the Property.
B. This Agreement specifically authorizes Us to act as Your Exclusive Broker for the following towns, counties and/or
properties:
Litchfield Country

II. Term of Authorization

A. This Authorization is in effect from July 27, 2019 to December 31, 2019 ,
inclusive.

III. Broker's Duties

A. We will use diligent efforts to find property within Your specifications.
B. We will negotiate on Your behalf for terms and conditions agreeable to You.
C. We will assist and act in Your interest regarding the location and purchase or exchange, as the case may be, of the Property.

IV. Buyer's Duties

A. You will tell Us about all past and current contacts with any real property or any other real estate agents and refer all leads
or information about the Property to Us.
B. You will cooperate with Us and be reasonably available to examine real property.
C. Upon request, You will give Us financial and personal information regarding your purchase abilities and needs.
D. Questions concerning the legal title to property, boundaries, tax considerations, property inspection, engineering, or
the uses or planned uses of neighboring properties should be referred to your attorney, tax advisor, building
inspector or appropriate governmental agency.

V. Other Terms and Conditions

A. You understand and agree that We may also become a seller's agent for the Property. In that event We would become dual
agents, representing both You and the seller. If this situation should arise, We will promptly disclose all relevant
information to You and discuss the appropriate course of action to take under the circumstances. We will give You a
disclosure form required by law. We will also discuss a dual agency consent agreement with You and present a statutory
form of such an agreement for Your review and signature.
B. You represent that You have not signed and will not sign any representation authorizations or agreements which are in
effect during the term of this Authorization with any other broker or brokerage firm for the location, purchase or exchange
of residential real estate located in the Towns identified in I(B) above.

BUYER'S INITIALS:

ERRBA - Revised 5/6/19 Page 1 of 3

William Raveis Real Estate - New Milford, 69 Bank St. New Milford CT 06776
Phone: 860-354-3906 Fax: 860-210-2263 Diana Newbert Sartoris Guzzo
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EXCLUSIVE RIGHT TO REPRESENT BUYER AUTHORIZATION

VI. Compensation ( Please Check Off Any & All Boxes That Apply)
NOTICE: THE AMOUNT OR RATE OF REAL ESTATE BROKER COMPENSATION IS NOT FIXED BY LAW. IT
IS SET BY EACH BROKER INDIVIDUALLY AND MAY BE NEGOTIABLE BETWEEN YOU AND THE BROKER.

[ ] You agree to pay Us a fee of $ OR % of the sales or exchange price of the

real property You purchase. This fee will be waived if We collect from the Seller or Listing Agency.
[ ] Other
[ ] You will pay Us a non-refundable retainer fee of $ , due and payable when You sign this
contract. Said retainer will be applied to any professional service fee that We may earn under this contract.

In addition to the above compensation and upon passing of title, You agree to pay William Raveis Real Estate, Inc. an
Administrative Fee of $195.00. This fee does not apply to purchases financed by government loans (VA, CHFA, FHA).

VII. Fair Housing

A. This Authorization is subject to the Connecticut General Statutes prohibiting discrimination in commercial and residential
real estate transactions (C.G.S. Title 46a, Chapter 814c).

VIII. Other Provisions

A. The Real Estate Broker may be entitled to certain lien rights pursuant to Subsection (d) (and Subsections e-q) of Section
20-325a of the Connecticut General Statutes.
B. You understand that, in an effort to assist You, William Raveis Real Estate, Inc. will offer to You other products and
services provided by its affiliate companies.
C. You agree to pay any costs and attorney's fees, which We may incur to collect monies due Us under this Agreement.
D. You/We agree that this Authorization may be transmitted between Us by facsimile machine. You/We intend that a faxed
Authorization containing either the original and/or copies of the signature of all parties shall constitute a binding
Authorization.
E. Buyer should not wire transfer any funds at any time without calling the intended recipient to confirm wiring
instructions, as email confirmation may not provide sufficient security.
F. Each Party waives the right to litigate in court or arbitrate any claim or dispute as a class action, either as a member of a
class or as a representative.

Information About the William Raveis Family of Companies - Visit www.raveis.com for details
Let me introduce you to our William Raveis Family of Services. Our family of companies partner in delivering quality services in a
one-stop shopping environment. Together we integrate the most comprehensive real estate, mortgage, insurance and attorney
services available to fulfill your specific real estate needs, with low mortgage and insurance rates.

William Raveis Mortgage is a full-service mortgage banker offering over 2,500 loan programs to choose from and access to rates
and products from over 30 investors, including FHA and other government loans. As one of the Northeast's top lenders, we are proud
to be able to offer competitive rates, quick commitments, instant on-line loan status updates, and private banker products for high-end
sellers and buyers.

William Raveis Insurance is committed to providing our customers with competitive rates, quality coverage and superior customer
service. We have premier partnerships with major insurance carriers nationwide such as Chubb, Fireman's Fund, One Beacon,
Travelers and offer coverage for home, automobile, renter's, flood, watercraft, excess liability, valuable items and other personal
insurance.

William Raveis Attorney Network works with clients to negotiate a favorable purchase contract and will coordinate and satisfy any
property insurance, title insurance, property sale requirements and more. We offer high quality legal services at competitive rates.

I understand that these services are available. Buyer's Initials:

BUYER'S INITIALS:
ERRBA - Revised 5/6/19 Page 2 of 3
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EXCLUSIVE RIGHT TO REPRESENT BUYER AUTHORIZATION

IT IS UNLAWFUL UNDER FEDERAL AND/OR STATE LAW TO DISCRIMINATE ON THE BASIS OF RACE, CREED,
COLOR, NATIONAL ORIGIN, ANCESTRY, SEX, SEXUAL ORIENTATION, MARITAL STATUS, AGE, LAWFUL
SOURCE OF INCOME, LEARNING DISABILITY, MENTAL RETARDATION, FAMILIAL STATUS AND MENTAL OR
PHYSICAL DISABILITY.

BROKER: William Raveis Real Estate, Inc.

By: Signature (Authorized Representative) Date

Diana Newbert
No. & Street 69 Bank Street

City, State, Zip New Milford, CT 06776

Phone Number: Home: Work: (860)354-3906

Email Address: [email protected]

Buyer
Signature: Date
Jeanine Marie Sartoris
Buyer
Signature: Date
Carolanne Guzzo
Buyer
Signature: Date

No. & Street

City, State, Zip

Phone Number: Home: Work:

Email Address: [email protected] [email protected]

ERRBA - Revised 5/6/19 Page 3 of 3

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AFFILIATED BUSINESS ARRANGEMENT DISCLOSURE STATEMENT

(To comply Real Estate Settlement Procedures Act, 24 CFR 3500, Appendix D)

This is to give you notice that William Raveis Real Estate, Inc., William Raveis–Massachusetts, LLC., William Raveis–Cape Cod,
LLC, William Raveis–Nantucket, LLC, William Raveis–Andover, LLC, William Raveis–New York, LLC, William Raveis–New
York City, LLC, William Raveis–Hamptons, LLC and William Raveis–Florida, LLC, (real estate brokers who provide complete
home selling and home finding services, including relocation and employee assistance [collectively hereafter referred to as
“BROKER”]), have a business and affiliated relationship with (1) William Raveis Mortgage, LLC (“Raveis Mortgage”), a mortgage
lender; (2) Kelsey-New York, LLC (“Kelsey-N.Y.”) and/or The Kelsey Company (collectively “Kelsey”), a title abstract and title
agency companies; and (3) William Raveis Insurance Agency, LLC (“Raveis Insurance”), an insurance agency providing, among
other things, homeowners insurance. We are pleased to recommend each of these companies. BECAUSE OF THIS BUSINESS
RELATIONSHIP AND/OR AFFILIATION, THIS REFERRAL MAY PROVIDE BROKER AND/OR ITS OWNERS WITH A
FINANCIAL OR OTHER BENEFIT.
[A] Set forth below is the estimated charge or range of charges for the settlement services listed. While we encourage you to use
Raveis Mortgage, Kelsey and Raveis Insurance, YOU ARE NOT REQUIRED TO DO SO as a condition for the settlement of
your loan on or purchase, sale, or refinance of your home or property. THERE ARE FREQUENTLY OTHER SETTLEMENT
SERVICE PROVIDERS AVAILABLE WITH SIMILAR SERVICES. YOU ARE FREE TO SHOP AROUND TO
DETERMINE WHETHER YOU ARE RECEIVING THE BEST SERVICES AND/OR THE BEST RATES FOR THOSE
SERVICES.
Origination Charge to Raveis Mortgage $1,090 - $1,590
(when acting as Lender) + 0% - 5% of the loan amount depending on the interest rate
Broker Compensation to Raveis Mortgage 0% - 3% of the loan amount
(when acting as Broker)
Title Exam / Search to Kelsey (CT & NY only) $400 - $450
Title Insurance to title insurer used by Kelsey $705 (for $200,000 standard Lender's policy only) to
(CT & NY only) $990 (for $250,000 Enhanced Owner's policy
which includes Enhanced Lender's policy). Cost will be based on actual
loan amount and purchase price and property state.
Hazard/Homeowner's Insurance to Raveis Insurance $400 - $500/Yr per $100,000 of replacement coverage
Flood Insurance to Raveis Insurance $405 - $1,180/Yr for $250,000 in dwelling coverage dependent on
property Flood Zone and elevation of building

[B] Set forth below is the estimated charge or range of charges for the settlement services of an attorney, credit reporting agency, or
real estate appraiser that Raveis Mortgage, as your lender, will require you to use, as a condition of your loan on this property, to
represent its interests in the transaction.
Appraisal Fees Based on property type, condition & location and loan type
To AV Appraisal Management Group $390 - $860
To StreetLinks $385 - $835
Inspection Fees
To AV Appraisal Management Group $150 - $200
To StreetLinks $100 - $200
Credit Report Fees to Kroll Factual Data $15 - $125 (depending on the number of borrowers & credit updates)

I/we have read this disclosure form and understand that BROKER is referring me/us to purchase the above-described services and
BROKER or its owners may receive a financial or other benefit as the result of that referral.

Customer Name (Please Print) Customer Signature Date

Customer Name (Please Print) Customer Signature Date

ABADS - Revised 1/5/16 - CT, MA, RI, FL Page 1 of 1
William Raveis Real Estate - New Milford, 69 Bank St. New Milford CT 06776 Phone: 860-354-3906 Fax: 860-210-2263 Sartoris Guzzo
Diana Newbert Produced with zipForm® by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026 www.zipLogix.com