1010 Holdings - Deal Registration Agreement

Deal Registration Agreement
Broker/Advisor Information:
Full Name

First NameLast Name
Company Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Jurisdiction
State/County
Are you a licensed broker-dealer in your jurisdiction?
Deal Information:
Deal/Project Name
Sector

Other
Company or Asset Owner Name
Deal Type
Commission Terms:
Requested Fee
Accept 1010 holdings' standard 1% policy?
Other compensation details (if applicable):
Required Documents:

In order to be considered, the following attachments must be uploaded below.
- Pro Forma
- Deal Summary or CIM
File Upload

Cancelof
Exclusivity Attestation:
By signing below, I confirm that:
1. I am the sole authorized broker representing this deal to 1010 Holdings.
2. No other party is being compensated for this same deal.
3. If I include other parties (co-brokers, sub-agents), I alone will pay them.
4. I am not receiving compensation from the counterparty unless listed below:
Signature
Your Name

First NameLast Name
Your Title
Your Email
example@example.com
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Please verify that you are human
Should be Empty: