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

Associate Name: *

Property Address (Including Unit No. - Mandatory): *

Move In Date: *

Your Client's Full Name (As Per Contract): *

Your Client's Postal/Mailing Address: *

City: *

State: *

Zip Code: *

Final Sale Price: *

Final Commision Listing Side: *

Final Commision Selling Side: *

What's Your Split For This Transaction (Ex. 70/30): *

SPECIAL COMMISSION NOTES FOR DISTRIBUTION

ARE YOU SHARING COMMISSION? *

Please describe the distribution for each person: *

ESCROW DISBURSEMENT INSTRUCTIONS

IS THE ESCROW WITH OUR OFFICE? *

Enter the Amount We Have in Escrow: *

Issue Check to Shelton and Stewart in the Amount Of: *

Issue Check to Other Company in the Amount Of: *

Balance Due to Landlord:

$0.00

Issue the Following Additional Checks: *

0/500 characters

(If any of the above checks needs to be sent by mail include mailing instructions for each check below):

MAILING INSTRUCTIONS *

0/500 characters

INFORMATION FOR INVOICING *** Complete ONLY IF you are the Listing Agent and 1st month in Escrow is not enough to pay your commission and the tenant's agent's commission.

Send Invoice to Landlord as follows : *

Invoice Amount: *

Landlord's Email: *

Landlord's Mailing address: *

REFERRALS AND CREDITS

Do We Need to Pay a Referral or Credit From Your Commission: *

Referral Amount
($ Amount Only): *

Name of Company or
Person Receiving Referral: *

REFERRAL PAYMENT DELIVERY METHOD

Please Mail Check To: *

0/500 characters

If The Referral Check Will Be Picked Up, Please Enter The Name Of The Person Picking Up: *

If Referral Payment Is To Be Sent By Wire, Please Send Wire Transfer (Email Wiring Instructions): *

0/500 characters

RENEWAL INFORMATION

Is the Lease Renewable? *

If Renewable, Let Us know When We Should We Remind You? +

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

MLS CHANGE OF STATUS

Are You The Listing Agent: *

Do you want to Change the Status to Rented? *

When Do You Want the Status Changed? * +

MLS#: *

Property Address: *

Property Type: *

Rented Price: *

Rented Date: *

Other Agent's Name: *

Other Agent's License: *

Other Agent's Company: *

Remove Sign: *

INFORMATION FOR MARKETING PURPOSES

Please Indicate How Your Client Was Sourced: *

IMPORTANT NOTES (If Any)

CONFIRMATION AND FORM SUBMISSION

Enter Your Email Address: *