Application To Sell Commission Receivable

Step 1 of 4

Agent Name *

Have you received an advance from another company OTHER THAN COMMISSION EXPRESS in the past 12 months?*

Do you currently have an outstanding advance WITH ANOTHER COMPANY?

For information purposes. Does not necessarily impact Commission Express ability to fund an advance.

Application To Sell Commission Receivable

Step 2 of 4

Personal Information

$

Company Information

Application To Sell Commission Receivable

Step 3 of 4

Property/Contract Information

Property City, State, Zip *

(Seller & Purchaser names are for documentation purposes only, We do not contact either party.)

$

$

$

Is this a short sale?*

New Construction*

I am the

(We will not contact lender without speaking with you first)

Commission Receivable

$

Do you want to sell your entire Commission Receivable?*

Application To Sell Commission Receivable

Step 4 of 4

File Uploads (PDF File Only)

Please attach any pertinent files to accompany your application. Once attached please press the submit button.
o Fully executed purchase & sale contract
o Pre-qual, loan approval or proof of funds
o MLS showing as pending
o Short sale approval (if applicable)
o Driver's license - only for new customer first advance

Declaration: 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.

Declaration Confirmation *

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.

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