Commission Express | Commission Advance for Realtors

Agent Information
This field is hidden when viewing the form
Application Email From
This field populates the 'from' email address as blank.
This field is hidden when viewing the form
application_home_branch_email
This field is hidden when viewing the form
Application User Status*
Agent First Name*
Agent Last Name*
Agent SSN*
Home Address*
City*
State*
Zipcode*
Agent Email*
Agent Cell Phone*

Company Information
Company Name*
Broker / Authorized Rep Name*
Company Address*
City*
State*
Zipcode*
Company Phone*
Broker Email
Additional Agent Information
Have you received an advance from another company other than Commission Express in the past 12 months?*
- Yes
- No
Do you currently have an outstanding advance with another company?*
- Yes
- No
Years with Current Company*
Year Licensed*
Bank Name*
Routing Number*
Account Number*
Agent Type?*
Settlement / Closing or Escrow Company Information
Company Name*
Settlement Rep / Agent Name
Address*
City*
State*
Company Zipcode*
Company Phone Number*
Settlement Representative Email*

Property / Contract Information
Property Address*
Property City*
Property State*
Zipcode*
Seller*
Purchaser*
Seller & Purchaser names are for documentation purposes only. We do not contact either party.
Reference Number
Lender Information
Lender*
If cash purchase, please enter "cash"
Loan Officer
Lender Phone
(We will not contact the lender without speaking to you first)
Is this a short sale?*
- Yes
- No
Is it bank approved?*
- Yes
- No
Contract Information
Final Contract Price*
New Construction?*
- Yes
- No
Ratification Date*
Month
Day
Year
Projected Closing / Settlement Date*
Month
Day
Year

Commission Receivable
Your Total Net Commission Due (After all deductions, expenses and splits)*
Do you want to sell your entire Commission Receivable?*
- Entire
- Partial
How much cash advance would you like to receive?*
Additional Information
Escrow Deposit*
Down Payment*
Number of Pending Settlements*
Number of Settlements in Past 12 Months*
Number of Active Listings*
Prior Year Income*

File Uploads

Please attach any pertinent files to accompany your application. Once attached please press the submit button.
Fully Executed Purchase & Sale Contract
Accepted file types: pdf, jpg, jpeg, Max. file size: 55 MB.
(55 MB Max)
Compensation - Buyer/Broker Agreement and/or Listing Agreement
Accepted file types: pdf, jpg, jpeg, Max. file size: 55 MB.
(55 MB Max)
Pre-Qual, Loan Approval or Proof of Funds
Accepted file types: pdf, jpg, jpeg, Max. file size: 5 MB.
(5 MB Max)
MLS (showing as pending)
Accepted file types: pdf, jpg, jpeg, Max. file size: 5 MB.
(5 MB Max)
Short Sale Approval (if applicable)
Accepted file types: pdf, jpg, jpeg, Max. file size: 5 MB.
(5 MB Max)
Driver's License (new customers only)
Accepted file types: pdf, jpg, jpeg, Max. file size: 5 MB.
(5 MB Max)
Miscellaneous
Accepted file types: pdf, jpg, jpeg, Max. file size: 30 MB.
(30 MB Max)
Disclaimer

By Clicking SUBMIT, I declare under penalty of perjury that each representations and acknowledgment contained in this application were and remain true and correct to the best of my information and belief. Furthermore, I acknowledge that any intentional or negligent misrepresentation of the information contained in this application may result in civil liability and/or criminal penalties and liability for monetary damages to Commission Express, its agents, successor and assign, and any other person who may suffer any loss due to reliance upon any misrepresentation which I have made in this application. Should Commission Express choose to do so, I authorize Commission Express to review my credit history and any other information in order to approve or decline my business application, service my account, and manage its relationship with me.
Declaration Confirmation*
- I Acknowledge the Above Declaration

Application to Sell Commission Receivable

Step 1 of 5

Agent Information

Company Information

Additional Agent Information

Settlement / Closing or Escrow Company Information

Property / Contract Information

Lender Information

Contract Information

Commission Receivable

Additional Information

File Uploads

Disclaimer

Contact Us