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Realty Solution

Property type: [ ] Sgf. [

C.D.A (Commission Disbursement Authorization ) SOUTHEAST

)_______________________________________

] Condo/th. [ ] Multi-family.[ ] Lot [ ] Commercial Property [ ] New Construct. Tel : ( )_______________________________ml/gf#_____________

Title Co.____________._______________ _Fax: (

Closer

___________________

PROP. Addr:______________:_______________________________City___________________________zip 77 _____ ____ ASSOCIATE:__________________________________ Tel:_____________________________F:________________________ Company Generated Lead Subject To Split [ ] 50/50 [ ] 60/40/ [ ] 70/30 [ ] Outside Locator Fee.

In-House Service Providers [ ] American Home shield

[__[ ABC Home Loans.

Contract Date: _________Closing date: ____________Doc. enclosed: [ ] Sale Contract [ ] Inspect .Report. [ ] Repair Agreement . [ ] Exec. Seller Disclosure [ ] Listing Agreement. [ ] Others:_____________________

SALE OR RENTAL PRICE...[ ] Selling Side [ ] Listing Side..................................................................$_______________ 1. COMMISSION + [ ] Bonus + [ ] Referral + [ ] $60.00 Buyer Adm [ ] Rental Commission . ...( 1) $_____________ {x } 1-A. DISBURSE Referral Fee[ ]35%/ [ ]25% on line 1). ___________________________ (1A) $_____________ 2. COMMISSION Subject To C-21 Royalty Fee ( LINE 1 Minus LINE 1-A )............ ........................ (2). $____________

2-A C-21 Royalty Fee ( 8% of line 2)............................................. ...................................(2A). $________________ { x} 2-B DISBURSE To Principle via Client Rebate Authorization Form ( C.R.A)............ .....(2B) $_____________ 3. COMMISSION Subject to Split ( line 2 minus lines 2A & 2B-) ................................................. . (3) $_______________ 4. 5. [ ] Listing Tr.Fee $______[ ] Selling Tr.$_________or ____% of line 3....................(4) ...............$______________

Other Office Fees $_____________

a. b. c. d.

( see itemized fees below) ......

....... ....................

(5)

e.

f.

E & O Insurance: [ ] Residential $49.00 [ ] Commercial $150.00......... $________________ Past Due Sponsoring Fee from _________/____ _/ 0___to______/_____/ 0__ _ $ ________________ Sponsoring Fee Deduction Charge...................................................... .$ 25.00 [ ] applied Late charge $2/day from ______ _______to __________= ______days_x 2 =_ $__________________ Buyer Admin Fee Paid by Buyer and Returned to office by Assoc.... ........ $ 60.00 [ ] applied

TOTAL OTHER FEES ( Sum of A -H and Enter this Amt. On line 5 above) . $________________ { x } 6. DISBURSE to C-21 Realty Solution (Add line 2A+4+5 ) .................... ....... (6) OFFICE CHECK $_________ { x } 7. DISBURSE to the Associate ( line 2A+3 MINUS line 6 ) ..................... (7) ASSOCIATE CHECK $_________ Disbursed Checks Recapped: $______________________Referral Fee to locator comapny_________________________________________________________ $______________________to Client $______________________to Broker Office $______________________to Associate Total $________________= Commission on line 1 CLOSER: PLEASE DELIVER ALL CHECKS + HUD DIRECTLY TO THE OFFICE BELOW:

Surcharge: 10% excess of $5000 on line 3 ( for 100% Plan Only)...

$ ______________

Century 21 Realty Solution Southeast 101 Southwestern Ste. 113 Sugar Land Tx 77478

_________________________________________ Signature of Broker or Authorized Staff Must Have Full Document Before Signing ________________________________________{ } Frank Filler Date Faxed OR Processed { } Dory Gordon ( ) Bea Flores

281-277-5777, Fax: 281-277-8232

revised June 22,07

Crested code: 25051612

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Microsoft Word - cda-southeast