Brokers- Agents

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Prospective Brokers, Agents.

REO Broker Application




First name:
Last name:
Company:
Co. address:
Co City:
Co. State:
Co. Zip code:


Office Phone:
Extension:

Home Phone:
Cell phone:
Office Fax:
E-mail:
Website:


Company Real Estate License #:
Company License State:
Company License Exp. Date:
MLS Memberships:
Broker Affiliations:
Experience:
How long as an agent?
How long as a Broker (If applicable)?:
How many Real Estate transactions closed?
REO Experience (If any)
BPO Experience (If any)

Can you receive & open MS Word & Excel Documents?:	Yes No
List Zip Codes separated by a comma for your market area:

References: Please supply two lenders or corporate servicers as reference:
Company:
Contact:
Phone:
Email:


Company:
Contact:
Phone:
Email:
Lawsuits:



Have you individually or has your firm been sued by a city, state, regulatory agency or financial institution?	Yes No
If yes, please explain the outcome of the law suit:
General Liability E&O Insurance:
Carrier name
Certificate number:
Effective Date:
Expiration date:
Policy Limit Amount:
Comments