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Commissin Express Commission Advance Application

Use the online form below to start the application process and GET PAID!

You can also download this form and fax to Commission Express of Delaware at (866) 731-1226 or Commission Express of Baltimore and Central PA at (866) 731-1226 by clicking here. *Indicates required field.
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*Agent Name:
*SS#:
*Email Address:
*Home Phone:
Home Fax:
Mobile Phone:
*Home Address:
 *City:
 *State:
 *ZIP:
*I am the: Listing Agent     Selling Agent            *My Home is : Owned     Leased
*Company Name:
*Broker/Auth. Rep.:
*Years with Present Company:
*Company Phone:
Company Fax:
*Year Licensed:
*Company Address:
*City:
*State:
 *ZIP:
*Bank (Personal):
*Account #:
*Property Address:
*City:
*State:
 *ZIP:
*Seller:
*Purchaser:
*Settlement Agent :
*Settlement Rep.:
*Settlement Rep Email :
*Escrow Number :
*Settlement Rep Phone:
Settlement Rep Fax:
*Settlement Company Address:
*City:
*State:
 *ZIP:
*Lender:
*Loan Officer :
*Lender Phone :
Lender Fax :
 
*Lender Address:
*City:
*State:
 *ZIP:
*Final Contract Price :
*Ratification Date (MM/DD/YYYY):

Date ALL contingencies except financing have been removed 		*Close or Escrow Date (MM/DD/YYYY):
*New Construction : Yes     No

*Receivable Amount:

(Agent's share of commission)
After ALL expenses & deductions, NET amount due to you

*Amount of Deposit

*Do you want to sell your entire Receivable, or just a part of it:
 All            Part

If Part, enter amount you would like to sell:
*Cash Deposit:
*Cash Down:
 *Number of Settlements Pending:

*Closed Last 12 Months:

*Number of Listings Current:

*Last Year's Total Income:
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Along with the completed application, we require the following documents:

  1. MLS Listing
  2. Copy of Purchase/Sales Contract + All Counters/Addendums
  3. Buyer's Loan Pre-Approval Letter

Please fax these documents to 866-731-1226 or e-mail them to manager@commissionexpressdelaware.com.
We will contact you upon receipt of all documents.

Certification:
I certify under penalty of perjury and of obtaining money under false pretenses that the information provided in this Application is true and correct as of today's date and acknowledge my understanding that any intentional or negligent misrepresentations of the information contained in this application may result in civil liability and/or criminal penalties and liability for monetary damages to Commission Express, it's agents, successors, and assigns, insurers and any other person who may suffer any loss due to reliance upon any misrepresentation which I have made on this application. I fully understand that Commission Express may at its own discretion check my consumer credit history to assist in the establishment and maintenance of my account.

I acknowledge the above certification

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Commission Express of Delaware and Commission Express of Baltimore and Central PA are Affiliate Members of: Suburban West REALTORS® Association (SWRA), Greater Harrisburg Association of REALTORS® (GHAR), Lancaster County Association of REALTORS® (LCAR), REALTORS® Association of York and Adams Counties (RAYAC), New Castle County Board of REALTORS® (NCCBOR), Harford County Association of REALTORS® (HCAR), Greater Baltimore Board of REALTORS® (GBBR).