Internal Commission Authorization Form and Acknowledgement

(Do not send this form to Escrow)

    The Associates Realty Group
    Corporate Offices
    155 N. Riverview Dr. #123
    Anaheim Hills, Ca. 92808
    Todays Date :
    Closing Date :
    Sales Price $ :
    The Associates RG Commission $ * :

    Property Address * :

    Below is the breakdown of the authorized disbursements and or deposits. The disbursements are going to be in separate checks as described below. If there are any changes to the disbursements below, then this must be approved by Corporate and a new ICAFA form is to be processed. Please check 1 of the commission delivery options below.

    Agent or Broker Associate:

    Name * :

    Email * :

    Brokerage fee $ :

    * On leases, or lower amount commission checks the amount collected for The Associates Realty Group is 10% up to $499.00 of the commission check per side.

    TC Name :

    TC Email * :

    TC Amount $ :

    E & O $ :

    Other $ :

    Payable to/Name :

    Other $ :

    Payable to/Name :

    Total Commission Due : $

    Overnight Fee (If Applicable) will apply actual cost
    **Please note if there is an overnight fee, The total commission paid will adjust.

    Direct Deposit to your bank account on file
    Yes Deposited to your Wells Fargo account
    **Please make sure we have your account information on file at Corporate.

    Yes Overnight to the address below Yes Signature Required Yes No Signature Required

    Number Street City State Zip Code

    Yes Pick up check and Corporate Office; 155N. Riverview Dr. Anaheim Hills, Ca 92808
    Yes Standard USPS mail to the address below

    Number Street City State Zip Code

    Agent Signature:

    Date:

    Yes Approval: By clicking here you have approved commission paid *

    YesOffice Credit $ :

    The Associates Realty Group Corporate
    Michelle Acosta

    Once approved, If there are any changes after the commission check (s) have been issued, there will be a $10 charge to process any duplicate check.