Broker Partner Registration

1 The Basics

2 Coverage Area

3 Service Info

4 Payments

Company Name*
Company Website*
Broker Name*
FirstLast
Primary Email*
Enter EmailConfirm Email
this email will be used to send you orders!
Primary Phone*
Primary Contact Person
provide if it's not the broker
Mailing Address*
Street AddressCityStateZip Code

States Covered
- 1
- 2
- 3
- 4
- 5
- 6
Primary State*
Primary State Counties Covered*
IMPORTANT: In order for us to service our clients and route orders to the correct broker, we need you to list all counties you service for this state, but please only include those counties where you are a member of the PRIMARY MLS
State 2
State 2 Counties Covered
State 3
State 3 Counties Covered
State 4
State 4 Counties Covered
State 5
State 5 Counties Covered
State 6
State 6 Counties Covered

Are you a Realtor.com "Showcase Listing" subscriber?*
- Yes
- No
Do you offer rental of Electronic Lock Box?*
- Yes
- No
Other Services You Offer
please describe other services you offer and the fees associated with them.
Does your state have "Minimum Service" laws?*
- Yes
- No
If so, how does that affect flat fee clients?*
describe how this affects clients and if there are extra fees we should know about.
Is flat fee service your primary business?*
- Yes
- No
How are leads sent to seller?*
please describe your methods of getting buyer leads to seller.

Expected Referral Fee*
Payment Preference*
- PayPal
- Check
we prefer PayPal and there is no fee for you!
PayPal Email*
Attach a Completed W-9
not required now, but eventually we'll need one
download blank W-9
Additional Comments