COMMISSION DISBURSEMENT AUTHORIZATION FORM

Broker LIC #586510

COMMISSION DISBURSEMENT AUTHORIZATION FORM

Title Company:_____________________________________________________

Phone:____________________________________ Fax:_____________________________________

Escrow Closer:_________________________________ Email: ___________________________________________

Property Address:________________________________________________GF#:_____________________________

Seller(s):____________________________________________Buyer(s):________________________________________

Listing Firm:___________________________________Agent Name:_________________________________________

Selling Firm:___________________________________Agent Name:_________________________________________

Sales Price: $__________________________Closing Date: ________________Funding Date:_________________

Mission Real Estate Group is to receive ________ % (Percent) commission as the Seller's

be distributed as follows:

Buyer's Broker, to

$_________________._____ to Mission Real Estate Group

$_________________._____ to __________________________________, an agent with Mission Real Estate Group.

(PLEASE MAKE AGENT PORTION PAYABLE DIRECTLY TO AGENT)

*If applicable, please pay a referral fee of: $_______________________ To be deducted from the commission of: ____________________________________________________ and paid at closing to: ____________________________________ (See Attached Referral Form for Referring Agent Information)

Checks should be made payable and mailed to:

Have Questions?

Mission Real Estate Group

2186 Jackson-Keller # 310 San Antonio, Texas 78217

Call: 210-201-6250 or Email: missionrealestategroup@

Agent must have CDA signed by broker prior to any disbursement.

_______________________________________________ BROKER SIGNATURE: (Company's Broker)

_________________________ DATE

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