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New Agent Form
This form is for new agents that would like to use Leverage Works as their transaction coordinator.
First name
Last name
Phone
Email
Mailing Address
Birthday
Month
Month
Day
Year
Real Estate License Number
Brokerage Name
Brokerage Phone
Brokerage License Number
Communication and System
Would you like to be CC'd on all email communication?
Yes
No
What is your preferred method of contact?
Call
Text
Email
Do you use a Compliance and/or Document Management System?
Yes
No
Compliance System Name
Compliance System Username
Compliance System Password
Do you have additional login information for another System? (e.g. electronic signature)
Yes
No
MLS Association Web Link
MLS Username
MLS Password
How do we submit compliance documents to your brokerage?
Preferred Inspector Information
Preferred Title Closer / Attorney Information
Any Information you would like to share with us to better assist you?
Compliance Checklist
Upload File
Do you have a Disbursement Authorization form? If Yes, attach below:
Upload File
Submit
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