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Ombuds Request
(
*
Denotes Required Fields)
Complainant Information
Name of Complainant:
*
Firm:
Address:
*
Email:
*
Preferred Phone for contact:
*
Best time to contact you:
Role in Transaction:
*
Buyer
Seller
Agent
Broker
Other
Subject property (if any):
Respondent Information
Name of Respondent:
*
Firm:
*
Address:
*
Email:
Phone:
*
Role in Transaction:
*
Listing Agent
Selling Agent
Broker
Other
Broker Lookup
Name of Respondent's Broker:
Broker's Email:
Broker's Phone:
What issue would you like the Ombuds to resolve?
Explain the issue:
*
[OPTIONAL] By checking the box below, I agree I am willing to participate in Voluntary Mediation to attempt to resolve a dispute. I understand Mediations are voluntary for both parties to participate in and there is no cost to participate.
Learn more about the mediation process
.
Check here to agree:
I understand and would like to try voluntary mediation
All information on this form is confidential.
The Connecticut REALTORS® will destroy this form and any other documents and materials pertaining to this matter at the conclusion of the Ombuds services.