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This is a Murtha Cullina form that can be used for MA Real Estate.
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NOTICE OF DESIGNATED AGENCY [For use when previous consent was obtained from seller in listing agreement and from buyer in buyer representation agreement] Broker previously gave notice of the potential for a designated agency relationship with both buyer and seller in connection with your real estate transaction. It was disclosed that a designated agent is a licensee who has been appointed by a broker or salesman to represent a buyer or seller and, with consent of that client, another licensee associated with the same broker is authorized to represent the other party in the same transaction. That disclosure was contained in the Exclusive Listing Agreement (for Seller) or in the Exclusive Buyer Representation Agreement (for Buyer). Broker now gives notice that a designated agency has occurred and that licensees affiliated with Broker represent both Buyer and Seller in connection with property described as: (the "Property"). More specifically, [name of affiliated licensee(s)] has/have been appointed as a Designated Seller's Agent(s) and [name of affiliated that licensee(s)] has/have been appointed as a Designated Buyer's Agent(s). BROKER Or Authorized Representative: Signature Print Name Date Acknowledgment [optional] I acknowledge receipt of this Notice of Designated Agency. SELLER BUYER [check one] Signature Print Name Date SELLER BUYER [check one] Signature Print Name Date © 2005 MASSACHUSETTS ASSOCIATION OF REALTORS® 03.25.05/348372