A&C Agent Name: * First Name Last Name PROPERTY ADDRESS and Customer Name * Deposit Information Date of deposit (or Date Mailed To Broker) * MM DD YYYY Close Date * MM DD YYYY Amount Deposited In Escrow (Or Amount of Check/s Mailed) * $ Type Of Deposit The money must be cleared and available in order for broker to cut checks. Cash Check Money Order Cashiers Check Wire Deposit Was Mailed To Brokerage Deposited By Me Wired by Title/ Escrow Agent Wired by Customer Disbursement Information Required Documents (Lease or Sales Contract & HUD) * In order to be paid for a rental you must submit a fully executed lease. In order to be paid for a sale you must submit a fully executed sales contract and HUD settlement statement. I Understand I Must Submit Required Documents In Order To Be Paid. Disburse Money As Follows * Name and amount that needs to be paid to each individual. Example: $1200 to Remax $2400 to Jim Johnson $800 to Arena Agent $295 Transaction Fee Was Charged to Buyer and or Seller Yes No Thank you!
