John,
You likely have the sample by now but please let me know if you are still needing it. Keep in mind, this is only used if what you will be paid is more than what you have listed on the exclusive buyer agreement. If you have X% plus $500 agent bonus, no disclosure is needed. They have already agreed to this.
I know many of the agents in the area see this as punishment and strict regulations set upon only our industry, but this is something I have verbally explained and visually showed them in our contract process anyway. One thing that has me a bit like a fish out of the water is having to inform them verbally if any home you show differs in any income to the agreed on amount.
I guess we can go for the humor..."You will really like this home since they are offering me a bonus if you buy it!"
Lynn Starkey-Shuler, Fayetteville, NC