Agent Registration
REAL ESTATE FILE SUBMISSION
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What is Your Name?
*
What is Your Email?
No Longer Required, But Recommended!
What is Your Phone Number?
What is Your Broker Admin Fee?
*
Who Are You Representing?
*
Buyer
Seller
Both
What is the Lead Type?
(Sphere, Referral, Zillow or Trulia, etc.)
What is the Commission % or $ Owed to You?
*
Is There a Commission Split?
*
Yes
No
How much is the Split in $ or %?
*
Who Do You Owe the Split To?
*
Is There a Referral Fee?
*
Yes
No
How much is the Referral in $ or %?
Who Do You Owe the Referral To?
*
Please Upload W9 If You Have It.
How Will Earnest Money be Delivered?
Trust Funds
Check
Unknown
What is the Address of the Sale?
Address Line 1
City
State / Province / Region
Postal Code
What is the MLS #?
If unknown or non-MLS leave blank
What is the Client's Name?
*
What is the Client's Email?
*
What is the Client's Phone Number?
Is There a Second Client?
Yes
No
What is the 2nd Client's Name?
What is the 2nd Client's Email?
What is the 2nd Client's Phone Number?
Do You Know the Seller's Title Information?
If Unknown Leave Blank
Do You Know the Buyer's Title Information?
If Unknown Leave Blank
Do You Know the Lender Information?
If Unknown Leave Blank
Should This Be Coordinated With Another Closing?
*
Yes
No
What is the Address of the Property to Coordinate With?
Address Line 1
City
State / Province / Region
Postal Code
Anything Else We Should Know About This Deal?
Upload Relevant Documents
Upload Multiple File
Click or drag files to this area to upload.
You can upload up to 7 files.
Where Should we Send a Copy of this Form to?
Typically Your Email Address.
Unlicensed Acknowledgment
*
I, the Real Estate Agent for this File Submission Form, warrant the truthfulness of the information provided in this application. I understand and accept all liability with this contract as those preparing it are UNLICENSED. By Clicking this box I acknowledge those who prepare this offer are UNLICENSED and ERRORS AND OMISSIONS are solely my responsibility.
Signature
*
Clear Signature
Please Type First and Last Name
*
Terms and Conditions
*
I understand checking this box constitutes a legal signature confirming I acknowledge and agree to the above Terms of Acceptance, Terms and Conditions, Privacy Policy, and Fee Owed.
Phone
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