ALL REQUIRED ITEMS MUST BE COMPLETED. IF A QUESTION DOES NOT APPLY PLEASE ENTER "N/A" OR "NONE", BUT DO NOT LEAVE BLANK. THE SYSTEM WILL NOT ACCEPT YOUR FORM.

KEY INFORMATION

Property Street Address: *

City: *

State: *

Associate Name: *

Your Client's Name: *

Your Client's Mailing Address: *

Your Client's Email Address: *

Your Client's Telephone No.: *

New Rental Amount (YEARLY/TOTAL): *

New Lease Beginning Date: *

New Lease Ending Date: *

Is This Lease Renewable: *

If Renewable, Let Us Know When We Should Remind You: * +

New Commission Amount Due to Shelton & Stewart: *

New Commission Amount Due to Other RE Company: *

Name of the Other RE Company: *

Year Built: *

***IF WE ARE PAYING THE OTHER COMPANY PLEASE INCLUDE INSTRUCTIONS FOR CHECK DELIVERY INCLUDING ADDRESS IF CHECK IS TO BE MAILED OR NAME OF PERSON WHO WILL PICK UP CHECK

Check Delivery Instructions: *

0/500 characters

***IMPORTANT: If we are paying the other Company a W-9 FORM from the other RE Company is required for us to issue a check. Please indicate Status of W9 Form below.

W-9 Form Status: *

Do you Need An Invoice? *

Name of Person We Need To Invoice: *

Address 'OR' Email Address for Invoice: *

0/500 characters

Amount to be Invoiced: *

If this Lease is Renewable, When Should We Remind You? +

IMPORTANT: Unless you provide a specific Notification Date above, our system will email you a reminder 90 days before expiration of the Lease.

IMPORTANT NOTES (IF ANY):

0/500 characters

CONFIRMATION AND FORM SUBMISSION

ENTER YOUR EMAIL ADDRESS FOR CONFIRMATION: *

RENEWAL FORM (LEASES ONLY)

KEY INFORMATION

CONFIRMATION AND FORM SUBMISSION