Agent Disbursement Authorization

Agent Disbursement Authorization

Please fill in this first page for our records. We will send over the authorization to the brokerage with a signature from the brokerage as soon as possible.
Agent Name

First NameLast Name
Title CompanyTitle Company*   Title Agent NameTitle Agent Name*
Title Phone Number: Area Code*   Phone Number*
Title Agent EmailTitle Agent Email
Property Address:Street Address*      City*   State*   Zip*    ,

Sales Information
Closing Date:      Date*
Sale Price:  $   Number*
Gross Commission on HUD:  $    Number*
Broker Transaction Fee of $395:               Number*
Did you use List2Close Transaction Coordinator fee $449?
Agent Net Commission:  $   Number*
Commission Split %:   Number*      (Example: 70% =0.7 )
Any other fees:      Number*   What are they?   *
Net Commission to Agent:     Number*
Comments:
Please Upload HUD/ALTA

Cancelof

Agent Disbursement Letter

Filled out by broker only
Property Address:   Street Address   Address Line 2   City   State   Zip

Closing Date:   Date
Investing N Florida Commission on HUD:
Broker Transaction Fee Paid By Client:      * Separate line item on HUD
MLS Fee Paid by Client:      * Separate line item on HUD
Dispersement to Agent:
Paid to Broker:
Transaction Coordinator Fee:      * Line item on HUD
- Payment Instructions:
- Please see attached wiring instructions for remittance.
- Please scan and email copies of the closing documents and this commission disbursement authorization to: Nadia@investingnflorida.com
- Please include address and agent name in all wires.
- IF documents have to be mailed - Send them to the following address
Investing N Florida, LLC
400 N Tampa Street Floor 15, Tampa Florida 33602
- FRIENDLY REMINDER: Please remember to turn in the settlement statement to the office within 48 Hours of the close of escrow. If documents are being mailed please upload the required documents.
- PLEASE NOTE: THE AGENT IS NOT AUTHORIZED TO MAKE ANY CHANGES TO THE ATTACHED INSTRUCTIONS. IF ANY CHANGES ARE NECESSARY, A REVISED COMMISSION DISBURSEMENT AUTHORIZATION FORM WILL BE ISSUED.
Broker Signature:
blanks
Should be Empty: