CDA Request Form

1
What's your name?* This field is required.If you are a team leader submitting on behalf of your team member, please input the team member's name here
2
Your Epique Email* This field is required.If you are a team leader submitting on behalf of your team member, please input the team member's email here
3
Were you recently approved to join any of these exclusive divisions?
Please Select
Luxury
Commercial
N/A
4
Which exclusive divisions are you a member of?
Please Select
Luxury
Commercial
N/A
5
Is this your FIRST CDA request for this transaction or a REVISED CDA request?* This field is required.
FIRST CDA
REVISED CDA
6
Are you on a Team?* This field is required.
YESNO
7
What type of Team are you on?* This field is required.
Traditional Team
Power Team
Family/Domestic Team
8
Are you the Team Leader?* This field is required.
Team LeaderNo - Team Member
9
Is this for your own deal or a team member's?* This field is required.
My DealTeam Member
10
Client Name(s)* This field is required.
11
Property Address* This field is required.
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
12
Are you representing both sides of the transaction?
Yes
No
13
Who are you representing?* This field is required.When representing both sides, please complete a CDA request form for each side.
Buyer
Seller
BPO
Referral Income
Landlord
Renter
Non-Refundable Retainer Fee Only
Miscellaneous Income
14
Is this transaction Residential or Commercial?* This field is required.
Residential
Commercial
15
What is your primary license state?* This field is required.
Street Address
Street Address Line 2
City
Please Select
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
State
Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
16
Please input the number of hours worked on this file for L&I purposes* This field is required.
17
Skyslope Inbox Email
example@example.com
18
Skyslope File Email (Located within the Skyslope File)* This field is required.
19
Does FMLS apply?* This field is required.Georgia ONLY
Yes
No
20
What's the Final Sales Price?* This field is required.For a Lease, please input the gross rent amount
Please do NOT use commas in this field
21
How are you charging commission?* This field is required.
Percentage
Flat Fee
22
How much are you charging as a flat fee?* This field is required.For a Referral or BPO, please input the amount you are receiving as commission.
23
What percentage are you charging?* This field is required.
24
Are you charging an additional transaction fee or admin fee?* This field is required.**Please only include additional fees charged to the client directly**
YESNO
25
How much is the transaction or admin fee?* This field is required.
26
Are you charging a Retainer Fee?* This field is required.
YESNO
27
Is the Retainer Fee Refundable?* This field is required.
RefundableNon-Refundable
28
How much is the Retainer Fee?* This field is required.
29
What is the name of the Team Leader?* This field is required.
30
Will {teamleadname}'s commission be payable to a business entity?
Business Entity PayoutNo
31
What {teamleadname}'s business entity name?
32
{teamleadname} Commission* This field is required.How much does your team leader get for this transaction?
Percentage
Flat Fee
33
How much is {teamleadname} getting in dollars?* This field is required.
34
What percentage of the Gross Commission is {teamleadname} receiving?* This field is required.
35
Would {teamleadname} like to donate to any of the following?* This field is required.What is Epique Cares? | What is NEMO?
NEMO Fund
Epique Cares
Neither
36
How much would {teamleadname} like to donate to the NEMO fund?* This field is required.What is NEMO?
37
How much would {teamleadname} like to donate to Epique Cares?* This field is required.What is Epique Cares?
38
Would {teamleadname} like to do any of the following?* This field is required.Company Stock Price | What's a Roth Solo 401K?
Epique X Stock (20% discount)
Invesco Solo 401K
SEP IRA
None
39
How much of {teamleadname}'s commission would {teamleadname} like to use to buy Epique X stock?* This field is required.Get Latest Company Stock Info
10% Commission5% Commission
40
Which 401K investment strategy would {teamleadname} like to use?* This field is required.
Pre-Tax
Post-Tax
Both
41
What Percentage would {teamleadname} like to contribute to your Pre-Tax Solo Roth 401K?* This field is required.What's a Roth Solo 401K?
42
What Percentage would {teamleadname} like to contribute to your Post-Tax Solo Roth 401K?* This field is required.What's a Roth Solo 401K?
43
Which SEP IRA strategy would {teamleadname} like to use?* This field is required.
Pre-Tax
Post-Tax
Both
44
What Percentage would {teamleadname} like to contribute to your Pre-Tax SEP IRA?* This field is required.
45
What Percentage would {teamleadname} like to contribute to your Post-Tax SEP IRA?* This field is required.
46
Do you have a Commission Advance on this transaction?* This field is required.If you are a team leader submitting on behalf of your team member, please input the team member's advance here
YESNO
47
Who do you owe the Commission Advance?* This field is required.If you are a team leader submitting on behalf of your team member, please input the team member's advance here
Please Select
Please Select
eCommission
Premier Commission
RealCommissions
Concord Commission Advance
Tongo
Residential Advance
Commission Express
Other (List in Notes Section)
48
How much should be applied to the Commission Advance?* This field is required.If you are a team leader submitting on behalf of your team member, please input the team member's advance here
49
Is this a Referral?* This field is required.Do you owe another agent a referral fee?
ReferralNot a Referral
50
Is this Referral inside Epique or outside Epique?* This field is required.
Epique Referral AgentOther Brokerage
51
Who is the Epique Referral Agent?* This field is required.Legal First and Last Name
52
Who is the Referring Brokerage?* This field is required.
53
Who is the Referring Agent?* This field is required.
54
How much does the Referring Agent receive?* This field is required.
55
Anyone else to Add to the CDA?* This field is required.
YESNO
56
List all Other Agents and their Commissions Below* This field is required.ex: John Smith, $300, Harry Styles, 2%, Beyonce Knowles, $250
Huge
Large
Normal
Small
Ok
Ok
57
Would {MainAgentName} like to donate to any of the following?* This field is required.What is Epique Cares? | What is NEMO?
NEMO Fund
Epique Cares
Neither
58
How much would {MainAgentName} like to donate to the NEMO fund?* This field is required.What is NEMO?
59
How much would {MainAgentName} like to donate to Epique Cares?* This field is required.What is Epique Cares?
60
Would {MainAgentName} like to do any of the following?* This field is required.Company Stock Price | What's a Roth Solo 401K?
Epique X Stock (20% discount)
Invesco Solo 401K
SEP IRA
None
61
How much of {MainAgentName}'s commission would you like to use to buy Epique X stock?* This field is required.Get Latest Company Stock Info
10% Commission5% Commission
62
Have you already setup your Solo Roth 401K?* This field is required.
Yes, it's setup.Not yet
63
You will need to have a 401K setup before you can contribute to your 401K.

Learn more about the Solo Roth 401K offered by Epique by clicking here.

Highlights:

Epique covers all fees associated with setup and maintenance of your Roth 401K.

Free Financial Planning is included in your plan.

High Income Limits

Note: Epique does not currently have a matching program. Roth 401K handled by Invesco. Epique does not have insights into Invesco's investing decisions and is not affiliated with Invesco or its subsidiaries. Please consult a financial planner before investing.
64
Which 401K investment strategy would {MainAgentName} like to use?* This field is required.
Pre-Tax
Post-Tax
Both
65
What Percentage would {MainAgentName} like to contribute to your Pre-Tax Solo Roth 401K?* This field is required.What's a Roth Solo 401K?
66
What Percentage would {MainAgentName} like to contribute to your Post-Tax Solo Roth 401K?* This field is required.What's a Roth Solo 401K?
67
Which SEP IRA strategy would {MainAgentName} like to use?* This field is required.
Pre-Tax
Post-Tax
Both
68
What Percentage would {MainAgentName} like to contribute to your Pre-Tax SEP IRA?* This field is required.
69
What Percentage would {MainAgentName} like to contribute to your Post-Tax SEP IRA?* This field is required.
70
Will {MainAgentName}'s commission be payable to a business entity?* This field is required.
Business Entity PayoutIndividual Payout
71
What is {MainAgentName}'s business entity name?* This field is required.
72
What changes are you requesting to be made to the current CDA?* This field is required.PLEASE INPUT SPECIFIC DETAILS SUCH AS NEW COMMISSION RATE, SALES PRICE, ETC.
Huge
Large
Normal
Small
Ok
Ok
73
Please upload all necessary documents for this transaction* This field is required.For a referral, please upload your referral agreement
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
74
What is the title company or closing officer's name?* This field is required.
75
What is the title company or closing officer's email?* This field is required.
example@example.com
76
What is the title company or closing officer's phone number?
Please enter a valid phone number.
77
Any Notes for the Transaction Team?
0/300
Huge
Large
Normal
Small
Ok
Ok
Should be Empty: