Rental Agent Form

In order for us to process your referral commission in a timely fashion, please complete and submit this form to us as soon as possible.

Showing a property, and having Duties Owed form signed by your client, does not guarantee a receipt of a referral commission from Southwest Management Group, LLC.

To be considered the procuring cause in a successful lease transaction, there must be an uninterrupted series of events which lead to an approved applicant, and a fully executed lease agreement.

Agent Name * First Middle Last
Agent Phone * - ### - ### ####
Agent Email *
Agent License Number *
Agent Public ID Number *
Brokerage/Office Information
Brokerage | Office Name *
Brokerage | Office Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Brokerage | Office Phone * - ### - ### ####
Property/Listing Information
MLS Listing Number *
Rental Property Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Primary Applicant/Tenant Name * First Middle Last
Co-Applicant/Tenant Name (2), if any First Middle Last
Co-Applicant/Tenant Name (3), if any First Middle Last
Have You Provided the Applicant with Duties Owed Form? *

Have You Provided the Applicant with Duties Owed Form? Yes No
Actual or Projected Move-In Date * / MM / DD YYYY
Referral Commission Due * $ . Dollars Cents
As stated in the MLS listing
Disclosure

By completing and executing this form, the Real Estate Agent/Realtor/Leasing Agent ("Agent") certifies that he/she is the showing Agent for the above mentioned property and the applicant/tenant. Agent has reviewed Clark County Recorder's information for any Notice of Default (foreclosure) or Trustee Sale corresponding with the list date for the property and states that no such records were found at the time of rental application submission, and/or lease agreement execution. Agent agrees and understands that the leasing fee/commission is earned upon successful execution of the lease agreement between the listing Broker and the applicant/tenant named herein, and that said fee will be made payable and sent to the Agent's Broker.
I have read and agree with the above disclosure *
Yes
Agent Signature *

Clear

Rental Agent Form

Rental Agent Form

Brokerage/Office Information

Property/Listing Information

Disclosure