Priority Application 2024

Agent Information
Agent Name
Phone Number
Package Type
E-mail

Property Information
Property Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
MLS #
Final Purchase Price
Home Warranty?
HOA?
Binding Date
Closing Date
Is Property
Is your client:

Commission
Total Commission %
Are team commissions and splits applicable (optional)
Company Split %
Agent Split %
Lead Source
Lead Sub Source
Is there a referral paid on this transaction?
Party to be paid:
If broker fee applies, who will be paying?

Other Information
Financing Type
Is there a referral paid on this transaction?
Does your client need instructions to coordinate earnest money?
Will Priority Title Coordinate Closings?

Contract Upload
Please upload the contract and all other supporting documents.

Contract must be bound and signed by all parties.
Select Files for Upload. Please combine all documents into a single PDF file.

Upload Files

Cancelof
Signature
By signing and submitting this transaction, you agree to the terms, conditions and associated fees.
Additional Notes or Message:
Anything we should know? (E.G., Divorce, death in family, special communication, etc.)
Should be Empty: