Digital Agent Commission Request Form

DUEK REALTY
COMMISSION REQUEST FORM
MonthDayYear
Form Fill Date
Agents Name*
First NameLast Name
Agent's Name*
Desired Name on Check
John Smith P.A.
Name on Check*
Type of Transaction*
Payment Installment
Property Type*
Lead Type*
Closing Date
MonthDayYear
Date
Client's Full Name or Companys Name*
First NameLast Name
Client or Company's Name*
Property Address*
Street Address
Street Address Line 2
CityState / Province
Postal / Zip CodeCountry
Total Contract Amount*
% Comission of Contract*
Ex: 3%, 5%, 7%
DR Gross Commission*
Check amount
Referral Fee
Name of Ref. Check
Referral Fee
Name of Ref. Check
% Office Split*
Ex: 25%
Office Commission Amount*
Amount stays in the office
Processing Fee*
Realtor Net Commission*
Amount that goes to realtor
Copy Of Contract & Addendums
Upload a File
Cancelof
HOA or Condo Disclosure
Upload a File
Cancelof
Settlement (HUD) Statement
Upload a File
Cancelof
MLS print out *
Upload a File
Cancelof
Copy of Articles of Corporation or LLC
Upload a File
Cancelof
Copy of Check Deposit
Upload a File
Cancelof
Exclusive Right to Lease
Upload a File
Cancelof
HOA or Condo Approval
Upload a File
Cancelof
Additional Comments
Should be Empty: